Active NPI
Mary Louise Ambrose
- Speech-Language Pathologist
- San Gabriel, CA
National Provider Identifier
1881526366
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 16612
- Practice address
- 401 S Walnut Grove Ave
San Gabriel, CA 91776-2000 - Phone
- (626) 287-0512
- NPI assigned
- Jun 1, 2026
- 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 | 16612 | CA | Primary |
Addresses
Primary practice location
401 S Walnut Grove Ave
San Gabriel, CA 91776-2000
Mailing address
2285 Cooley PL
Pasadena, CA 91104-3413
Phone (626) 451-5400
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 |
|---|---|---|---|
| 16612 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1780272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1780272000000",
"number": "1881526366",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2285 COOLEY PL",
"city": "PASADENA",
"state": "CA",
"postal_code": "911043413",
"telephone_number": "626-451-5400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 S WALNUT GROVE AVE",
"city": "SAN GABRIEL",
"state": "CA",
"postal_code": "917762000",
"telephone_number": "626-287-0512"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AMBROSE",
"first_name": "MARY",
"middle_name": "LOUISE",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-06-01",
"last_updated": "2026-06-01",
"certification_date": "2026-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "16612",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Gabriel, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.