Kendal C Villa, CCC - SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

103783 Issued in TX

Practice address

5606 N Navarro St Ste 200
Victoria, TX 77904-1758

Phone

(361) 220-6455

NPI assigned

May 17, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Miss Kendal C Perez Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1770790040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 PIN OAK CT",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779017292",
            "telephone_number": "361-701-8865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5606 N NAVARRO ST STE 200",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779041758",
            "telephone_number": "361-220-6455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLA",
        "first_name": "KENDAL",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "CCC - SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-17",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "103783",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPEECH LICENSE",
            "identifier": "102906",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "164704201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KENDAL",
            "last_name": "PEREZ",
            "middle_name": "C",
            "prefix": "MISS",
            "credential": "M.S. SLP CFY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Speech-Language Pathologist in Victoria, TX
• Providers in Victoria, TX by specialty
• Speech-Language Pathologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 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.