Naomi Miriam Ellison, MS
Individual provider Active NPI Speech-Language Pathologist · Porter Ranch, CA
NPI 1942522685 · NPPES record last updated Feb 22, 2010
Key facts
- NPI
- 1942522685
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- RPE 6185 (CA)
- Practice address
- 19158 Lahey St Unit 3
Porter Ranch, CA 91326-3751 - Phone
- (818) 517-3795
- NPI assigned
- Feb 22, 2010
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPE 6185 | CA | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | RPE 6185 | CA | Yes |
Addresses
Primary practice location
19158 Lahey St Unit 3
Porter Ranch, CA 91326-3751
Mailing address
19158 Lahey St Unit 3
Porter Ranch, CA 91326-3751
Phone (818) 517-3795
NPI Registry JSON
{
"created_epoch": "1266796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1266796800000",
"number": "1942522685",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19158 LAHEY ST UNIT 3",
"city": "PORTER RANCH",
"state": "CA",
"postal_code": "913263751",
"telephone_number": "818-517-3795"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19158 LAHEY ST UNIT 3",
"city": "PORTER RANCH",
"state": "CA",
"postal_code": "913263751",
"telephone_number": "818-517-3795"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLISON",
"first_name": "NAOMI",
"middle_name": "MIRIAM",
"credential": "MS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-02-22",
"last_updated": "2010-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "RPE 6185",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Porter Ranch, CA
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All providers in Porter Ranch, CA · Speech-Language Pathologist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 22, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.