Active NPI
Rebecca Leigh Blatz, SPEECH PATHOLOGIST
- Speech-Language Pathologist
- Corona, CA
National Provider Identifier
1891209425
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 29360
- Practice address
- 785 Yorkshire Way
Corona, CA 92879-3143 - Phone
- (951) 264-4226
- NPI assigned
- Nov 17, 2017
- 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 | 29360 | CA | Primary |
Addresses
Primary practice location
785 Yorkshire Way
Corona, CA 92879-3143
Mailing address
880 Hotspring Dr
Corona, CA 92880-6756
Phone (951) 264-4226
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 |
|---|---|---|---|
| 29360 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1510876800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1594080000000",
"number": "1891209425",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "880 HOTSPRING DR",
"city": "CORONA",
"state": "CA",
"postal_code": "928806756",
"telephone_number": "951-264-4226"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "785 YORKSHIRE WAY",
"city": "CORONA",
"state": "CA",
"postal_code": "928793143",
"telephone_number": "951-264-4226"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLATZ",
"first_name": "REBECCA",
"middle_name": "LEIGH",
"credential": "SPEECH PATHOLOGIST",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-11-17",
"last_updated": "2020-07-07",
"certification_date": "2020-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "29360",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Corona, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 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.