Grace Bumacod, SPEECH PATHOLOGIST

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

19239 Issued in CA

Practice address

245 W Sierra Madre Blvd
Sierra Madre, CA 91024-2355

Phone

(626) 822-5992

NPI assigned

Aug 12, 2019

Last updated

Aug 12, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Trellis Physical Therapy a Professional Rehab Group Inc.

  • Physical Therapist
  • Los Angeles, CA
  • NPI 1730245838
  NPD (past)

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

{
    "created_epoch": "1565568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565568000000",
    "number": "1922654482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "528 E VERDUGO AVE APT L",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915012339",
            "telephone_number": "818-452-8124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 W SIERRA MADRE BLVD",
            "city": "SIERRA MADRE",
            "state": "CA",
            "postal_code": "910242355",
            "telephone_number": "626-822-5992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUMACOD",
        "first_name": "GRACE",
        "credential": "SPEECH PATHOLOGIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-12",
        "last_updated": "2019-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "19239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bellatriss Nursing Inc
• Cynthia Ann Boland, LMFT
• Mary Jo Boyd-Prince, LMFT
• Brad Stenberg, D.MFT.
• Leeann Brown, BCA BA
• Brittany Leann Burian, MS
• Jessica Cabrera, LCSW
• California Mindfulness Center Inc
• Cathleen E Cash, MFT
• Caulfield Business Group, Inc (Occuplaytion)

• Speech-Language Pathologist in Sierra Madre, CA
• Providers in Sierra Madre, 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 Aug 12, 2019; 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.