Active NPI
Kelly Elaine Gardina, MS, CCC-SLP
- Speech-Language Pathologist
- Encino, CA
National Provider Identifier
1871842211
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 8385
- Practice address
- 17609 Ventura Blvd Ste 215
Encino, CA 91316-5126 - Phone
- (818) 501-8352
- NPI assigned
- Aug 30, 2012
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Assistant | 2355S0801X | 1629 | CA | |
| Speech-Language Pathologist | 235Z00000X | 8385 | CA | Primary |
Addresses
Primary practice location
17609 Ventura Blvd Ste 215
Encino, CA 91316-5126
Mailing address
27200 Tourney Rd Ste 255
Valencia, CA 91355-4983
Phone (661) 222-9901
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1629 | CA | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1346284800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1460332800000",
"number": "1871842211",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27200 TOURNEY RD STE 255",
"city": "VALENCIA",
"state": "CA",
"postal_code": "913554983",
"telephone_number": "661-222-9901",
"fax_number": "661-222-9326"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17609 VENTURA BLVD STE 215",
"city": "ENCINO",
"state": "CA",
"postal_code": "913165126",
"telephone_number": "818-501-8352"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARDINA",
"first_name": "KELLY",
"middle_name": "ELAINE",
"name_prefix": "Mrs.",
"credential": "MS, CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-08-30",
"last_updated": "2016-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "2355S0801X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Speech-Language Assistant",
"state": "CA",
"license": "1629",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "8385",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Encino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.