Individual provider Active NPI

Jasmin J Herrera

  • Speech-Language Assistant
  • Queen Creek, AZ
National Provider Identifier
1922752385
Registry record updated Feb 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
SLPA13421 Issued in AZ
Practice address
20435 S Old Ellsworth Rd
Queen Creek, AZ 85142-9676
Phone
(480) 987-5940
NPI assigned
Feb 4, 2022
Last updated
Feb 4, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X 217000405 IL
Speech-Language Assistant 2355S0801X SLPA13421 AZ Primary

Addresses

Primary practice location

20435 S Old Ellsworth Rd
Queen Creek, AZ 85142-9676

Mailing address

41629 N Ranch Dr
San Tan Valley, AZ 85140-3206
Phone (773) 818-1498

Other practice location 1

20750 S 214th St
Queen Creek, AZ 85142-7749
Phone (480) 987-7400

Other practice location 2

23636 S 204th St
Queen Creek, AZ 85142-9677
Phone (480) 987-5920

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

LicenseStateTypeSpecialty
SLPA13421AZMDSpeech-Language Assistant
217000405ILMDSpeech-Language Assistant

NPI Registry JSON

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

{
    "created_epoch": "1643932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643932800000",
    "number": "1922752385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41629 N RANCH DR",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851403206",
            "telephone_number": "773-818-1498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20435 S OLD ELLSWORTH RD",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851429676",
            "telephone_number": "480-987-5940"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20750 S 214th St",
            "address_purpose": "LOCATION",
            "city": "Queen Creek",
            "state": "AZ",
            "postal_code": "851427749",
            "country_code": "US",
            "telephone_number": "480-987-7400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "23636 S 204th St",
            "address_purpose": "LOCATION",
            "city": "Queen Creek",
            "state": "AZ",
            "postal_code": "851429677",
            "country_code": "US",
            "telephone_number": "480-987-5920",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERRERA",
        "first_name": "JASMIN",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-04",
        "last_updated": "2022-02-04",
        "certification_date": "2022-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "IL",
            "license": "217000405",
            "primary": false
        },
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "AZ",
            "license": "SLPA13421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Queen Creek, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2022; 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.