Individual provider Active NPI

Jennifer Santiago

  • Speech-Language Assistant
  • Fountain Valley, CA
National Provider Identifier
1952125296
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
7493 Issued in CA
Practice address
10061 Talbert Ave Ste 104
Fountain Valley, CA 92708-5159
Phone
(714) 642-5420
NPI assigned
Nov 13, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X 7493 CA Primary

Addresses

Primary practice location

10061 Talbert Ave Ste 104
Fountain Valley, CA 92708-5159

Mailing address

10061 Talbert Ave Ste 104
Fountain Valley, CA 92708-5159

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
7493CAMDSpeech-Language Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Avid Speech Therapy Speech-Language Assistant CurrentSince Nov 17, 2024 Accepting new patients

Locations

10061 Talbert Ave
Ste 104
Fountain Valley, CA 92708
Phone (714) 272-3090

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1731456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1952125296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10061 TALBERT AVE STE 104",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927085159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10061 TALBERT AVE STE 104",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927085159",
            "telephone_number": "714-642-5420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTIAGO",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-13",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "CA",
            "license": "7493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 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.