Active NPI
Javonne Mullins
- Speech-Language Pathologist
- San Juan Capistrano, CA
National Provider Identifier
1801274071
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 22896
- Practice address
- 33466 Calle Miramar
San Juan Capistrano, CA 92675-4921 - Phone
- (740) 606-7775
- NPI assigned
- May 8, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 22896 | CA | Primary |
Addresses
Primary practice location
33466 Calle Miramar
San Juan Capistrano, CA 92675-4921
Mailing address
33466 Calle Miramar
San Juan Capistrano, CA 92675-4921
Phone (740) 606-7775
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
| License | State | Type | Specialty |
|---|---|---|---|
| 22896 | CA | MD | Pediatric Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1431043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1440028800000",
"number": "1801274071",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "33466 CALLE MIRAMAR",
"city": "SAN JUAN CAPISTRANO",
"state": "CA",
"postal_code": "926754921",
"telephone_number": "740-606-7775"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "33466 CALLE MIRAMAR",
"city": "SAN JUAN CAPISTRANO",
"state": "CA",
"postal_code": "926754921",
"telephone_number": "740-606-7775"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MULLINS",
"first_name": "JAVONNE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-05-08",
"last_updated": "2015-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "22896",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Juan Capistrano, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.