Pom Pom Speech & Language Therapy, Inc.

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

POM POM SPEECH & LANGUAGE THERAPY, INC.

Practice address

324 E Aeroplane Blvd.
Big Bear City, CA 92314

Phone

(661) 993-8037

NPI assigned

May 29, 2024

Last updated

Jun 2, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kylie Puckett, M.A., CCC-SLPNPI 1447920947

Title

Owner/ Speech Therapist

Phone

(661) 993-8037

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kylie Puckett, CCC-SLP

  • Speech-Language Pathologist
  • Los Angeles, CA
  • NPI 1447920947
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1716940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717286400000",
    "number": "1912747890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2049",
            "city": "BIG BEAR CITY",
            "state": "CA",
            "postal_code": "923142049",
            "telephone_number": "661-993-8037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 E AEROPLANE BLVD.",
            "city": "BIG BEAR CITY",
            "state": "CA",
            "postal_code": "92314",
            "telephone_number": "661-993-8037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POM POM SPEECH & LANGUAGE THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-29",
        "last_updated": "2024-06-02",
        "certification_date": "2024-06-02",
        "status": "A",
        "authorized_official_last_name": "PUCKETT",
        "authorized_official_first_name": "KYLIE",
        "authorized_official_title_or_position": "OWNER/ SPEECH THERAPIST",
        "authorized_official_telephone_number": "661-993-8037",
        "authorized_official_credential": "M.A., CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Big Bear City, CA
• Providers in Big Bear City, CA by specialty
• Speech-Language Pathologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.