Jessica Da, SLP-CCC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

1720 Ardmore Ave
Apt 224
Hermosa Beach, CA 90254-3025

Phone

(832) 506-0373

NPI assigned

Oct 7, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1412640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420761600000",
    "number": "1861895666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 ARDMORE AVE",
            "address_2": "APT 224",
            "city": "HERMOSA BEACH",
            "state": "CA",
            "postal_code": "902543025",
            "telephone_number": "832-506-0373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 ARDMORE AVE",
            "address_2": "APT 224",
            "city": "HERMOSA BEACH",
            "state": "CA",
            "postal_code": "902543025",
            "telephone_number": "832-506-0373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DA",
        "first_name": "JESSICA",
        "credential": "SLP-CCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-07",
        "last_updated": "2015-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Hermosa Beach, CA
• Providers in Hermosa Beach, 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 Jan 9, 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.

Verify at the official NPI Registry.