Functional Speech Therapy Inc

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

FUNCTIONAL SPEECH THERAPY INC

Doing business as

Functional Speech Therapy

Practice address

340 Via Vista Dr
Redlands, CA 92373-7157

Phone

(949) 547-3909

NPI assigned

Jul 19, 2023

Organization subpart

No

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

Authorized official

Name

Jordan Wright Gonzalez, MS. CCC-SLP

Title

Ceo

Phone

(949) 547-3909

Specialties & licenses 1

Addresses

Other names 1

• Functional Speech Therapy Doing business as

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

{
    "created_epoch": "1689724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689724800000",
    "number": "1861172363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 VIA VISTA DR",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923737157",
            "telephone_number": "949-547-3909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 VIA VISTA DR",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923737157",
            "telephone_number": "949-547-3909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUNCTIONAL SPEECH THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-19",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A",
        "authorized_official_last_name": "WRIGHT GONZALEZ",
        "authorized_official_first_name": "JORDAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "949-547-3909",
        "authorized_official_credential": "MS. CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Functional Speech Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Matthew John Frydendall
• Amanda Frye, R.D.
• David Fukuda, M.D.
• Fuller and Lemley Dental Corp (Pediatric Dentistry of Redlands)
• Cameron Fuller, DDS MS
• Sina Ameen Furutan
• Phillip Gable, PH.D.
• Stuart Gaede
• Travis Gaines
• Erica Leigh Gallegos, D.N.P.

• Speech-Language Pathologist in Redlands, CA
• Providers in Redlands, 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 Jul 19, 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.