Active NPI
Tessa Marie Jansen, M.A. CCC-SLP
- Speech-Language Pathologist
- Murrieta, CA
National Provider Identifier
1942592647
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SP19601
- Practice address
- 25102 Jefferson Ave
Suite D
Murrieta, CA 92562-1707 - Phone
- (951) 461-1190
- NPI assigned
- May 12, 2011
- 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 | SP19601 | CA | Primary |
Addresses
Primary practice location
25102 Jefferson Ave
Suite D
Murrieta, CA 92562-1707
Mailing address
25102 Jefferson Ave
Suite D
Murrieta, CA 92562-1707
Phone (951) 461-1190
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP19601 | CA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lucid Speech and Language Clinic, Inc. | Speech-Language Pathologist | Past | Accepting new patients |
| Lucid Speech & Language | Speech-Language Pathologist | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Speech-Language Pathologist
- Murrieta, CA
- NPI 1336240324
-
- Speech-Language Pathologist
- Murrieta, CA
- NPI 1457805251
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1305158400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1340064000000",
"number": "1942592647",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25102 JEFFERSON AVE",
"address_2": "SUITE D",
"city": "MURRIETA",
"state": "CA",
"postal_code": "925621707",
"telephone_number": "951-461-1190"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25102 JEFFERSON AVE",
"address_2": "SUITE D",
"city": "MURRIETA",
"state": "CA",
"postal_code": "925621707",
"telephone_number": "951-461-1190"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JANSEN",
"first_name": "TESSA",
"middle_name": "MARIE",
"credential": "M.A. CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-05-12",
"last_updated": "2012-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "SP19601",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Murrieta, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.