Active NPI
Alyssa Holguin, M.S. CCC-SLP
- Speech-Language Pathologist
- Gardena, CA
National Provider Identifier
1871989418
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 23309
- Practice address
- 1110 W 164TH St
Gardena, CA 90247-4803 - Phone
- (310) 662-3211
- NPI assigned
- Apr 10, 2015
- Sex
- Female
- Sole proprietor
- Yes
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 | 23309 | CA | Primary |
Addresses
Primary practice location
1110 W 164TH St
Gardena, CA 90247-4803
Mailing address
1110 W 164TH St
Gardena, CA 90247-4803
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 |
|---|---|---|---|
| 23309 | CA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1428624000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1589155200000",
"number": "1871989418",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1110 W 164TH ST",
"city": "GARDENA",
"state": "CA",
"postal_code": "902474803"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1110 W 164TH ST",
"city": "GARDENA",
"state": "CA",
"postal_code": "902474803",
"telephone_number": "310-662-3211"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLGUIN",
"first_name": "ALYSSA",
"credential": "M.S. CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-04-10",
"last_updated": "2020-05-11",
"certification_date": "2020-05-11",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "23309",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gardena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.