Individual provider Active NPI

Nicole A Holman

  • Speech-Language Pathologist
  • Anaheim, CA
National Provider Identifier
1770191769
Registry record updated Jan 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
36801 Issued in CA
Practice address
1076 S Romano CT
Anaheim, CA 92808-2434
Phone
(760) 208-3446
NPI assigned
Jul 16, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2026

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 36801 CA Primary

Addresses

Primary practice location

1076 S Romano CT
Anaheim, CA 92808-2434

Mailing address

1076 S Romano CT
Anaheim, CA 92808-2434
Phone (760) 208-3446

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230301001641 CA Practitioner - Qualified Speech Language Pathologist 0547633125 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

Anaheim, CA 92807
Phone (714) 251-6356

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
36801CAMDMarriage & Family Therapist
17586CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Instrumental Speech Language Pathology Professionals Inc. Speech-Language Pathologist CurrentSince Feb 24, 2023 Accepting new patients
Eastern New Mexico University Speech-Language Pathologist PastSince Nov 12, 2023 Accepting new patients

Locations

5475 E La Palma Ave
Ste 206
Anaheim, CA 92807
Phone (714) 251-6356

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": "1594857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767916800000",
    "number": "1770191769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1076 S ROMANO CT",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928082434",
            "telephone_number": "760-208-3446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1076 S ROMANO CT",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928082434",
            "telephone_number": "760-208-3446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMAN",
        "first_name": "NICOLE",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-16",
        "last_updated": "2026-01-09",
        "certification_date": "2026-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "36801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.