Individual provider Active NPI

Min Shon Belgrave, CCC-SLP

  • Speech-Language Pathologist
  • Walnut Creek, CA
National Provider Identifier
1730945791
Registry record updated Feb 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
24770 Issued in CA
Practice address
675 Ygnacio Valley Rd Ste B212
Walnut Creek, CA 94596-8209
Phone
(510) 250-9199
NPI assigned
Feb 26, 2024
Last updated
Feb 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 24770 CA Primary

Addresses

Primary practice location

675 Ygnacio Valley Rd Ste B212
Walnut Creek, CA 94596-8209

Mailing address

825 S Myrtle Ave Unit 518
Monrovia, CA 91016-8624
Phone (626) 646-9747

Other names 1

  • Min Shon Former name

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
24770CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Seven Bridges Speech Pathology Inc Speech-Language Pathologist PastSince Mar 3, 2024 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1708905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708905600000",
    "number": "1730945791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 S MYRTLE AVE UNIT 518",
            "city": "MONROVIA",
            "state": "CA",
            "postal_code": "910168624",
            "telephone_number": "626-646-9747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 YGNACIO VALLEY RD STE B212",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945968209",
            "telephone_number": "510-250-9199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELGRAVE",
        "first_name": "MIN",
        "middle_name": "SHON",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-26",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "24770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIN",
            "last_name": "SHON",
            "credential": "CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Walnut Creek, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2024; 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.