Tanya A Keller, M.S CCC-SLP ED.S

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP27018 Issued in CA

Practice address

4735 Bancroft St Apt 6
San Diego, CA 92116-1667

Phone

(617) 780-5193

Fax

(619) 362-9930

NPI assigned

Apr 16, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Tanya Scott Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686182400000",
    "number": "1780809822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4735 BANCROFT ST APT 6",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921161667",
            "telephone_number": "617-780-5193",
            "fax_number": "619-362-9930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4735 BANCROFT ST APT 6",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921161667",
            "telephone_number": "617-780-5193",
            "fax_number": "619-362-9930"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8 Whittemore Rd",
            "address_purpose": "LOCATION",
            "city": "Framingham",
            "state": "MA",
            "postal_code": "017013244",
            "country_code": "US",
            "telephone_number": "617-780-5193",
            "fax_number": "617-752-3750",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLER",
        "first_name": "TANYA",
        "middle_name": "A",
        "credential": "M.S CCC-SLP ED.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-16",
        "last_updated": "2023-06-08",
        "certification_date": "2023-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MA",
            "license": "6650",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "SP27018",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "SP0175",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tanya.keller@sdaacslp.com",
            "affiliation": "N",
            "address_1": "1114 Arnold Way",
            "city": "Alpine",
            "state": "CA",
            "country_code": "US",
            "postal_code": "919012722",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TANYA",
            "last_name": "SCOTT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mark Keller
• Mary Keller
• Michaela Keller
• Solana Josphine Keller
• Steven Edward Keller, PT
• Elizabeth Kellerman
• Cheyenne Sierra Kelley
• Danae Kelley
• Danielle Kelley
• Holly Elizabeth Kelley, LMFT

• Speech-Language Pathologist in San Diego, CA
• Providers in San Diego, CA by specialty
• Speech-Language Pathologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2023; 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.