Individual provider Active NPI

Lelani Myburgh, SLPA

  • Speech-Language Assistant
  • San Diego, CA
National Provider Identifier
1730653296
Registry record updated Jan 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
SPA-613 Issued in CA
Practice address
9466 Black Mountain Rd Ste 100
San Diego, CA 92126
Phone
(858) 689-2027
Fax
(858) 397-2172
NPI assigned
Jan 17, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X SPA-613 CA Primary

Addresses

Primary practice location

9466 Black Mountain Rd Ste 100
San Diego, CA 92126

Mailing address

9466 Black Mountain Rd Ste 100
San Diego, CA 92126-4550
Phone (858) 689-2027

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SPA-613CAMDSpeech-Language Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Autism Group, Inc. Past Accepting new patients
Therapeutic Approach to Growth, Inc. Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1547683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547683200000",
    "number": "1730653296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9466 BLACK MOUNTAIN RD STE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921264550",
            "telephone_number": "858-689-2027",
            "fax_number": "858-397-2172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9466 BLACK MOUNTAIN RD STE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92126",
            "telephone_number": "858-689-2027",
            "fax_number": "858-397-2172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYBURGH",
        "first_name": "LELANI",
        "credential": "SLPA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-17",
        "last_updated": "2019-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "CA",
            "license": "SPA-613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.