Active NPI
Ashley Nicole Mark
- Speech-Language Pathologist
- Montebello, CA
National Provider Identifier
1902425176
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 29796
- Practice address
- 900 S Greenwood Ave
Montebello, CA 90640-5816 - Phone
- (323) 721-4605
- NPI assigned
- Apr 8, 2020
- 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 | 29796 | CA | Primary |
Addresses
Primary practice location
900 S Greenwood Ave
Montebello, CA 90640-5816
Mailing address
12902 Barranca LN
Norwalk, CA 90650-3306
Phone (323) 365-4065
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 |
|---|---|---|---|
| 29796 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1586304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1586304000000",
"number": "1902425176",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12902 BARRANCA LN",
"city": "NORWALK",
"state": "CA",
"postal_code": "906503306",
"telephone_number": "323-365-4065"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 S GREENWOOD AVE",
"city": "MONTEBELLO",
"state": "CA",
"postal_code": "906405816",
"telephone_number": "323-721-4605"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARK",
"first_name": "ASHLEY",
"middle_name": "NICOLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-04-08",
"last_updated": "2020-04-08",
"certification_date": "2020-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "29796",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Montebello, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 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.