Active NPI
Rachel N Van Vliet, M.S., CCC-SLP
- Speech-Language Pathologist
- Tustin, CA
National Provider Identifier
1962000893
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 30656
- Practice address
- 3002 Dow Ave Ste 114
Tustin, CA 92780-7247 - Phone
- (714) 731-4668
- NPI assigned
- Oct 13, 2020
- 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 | 30656 | CA | Primary |
Addresses
Primary practice location
3002 Dow Ave Ste 114
Tustin, CA 92780-7247
Mailing address
1401 Brighton St
La Habra, CA 90631-3201
Phone (562) 448-8217
Other practice location 1
11019 Valley Home Ave
Whittier, CA 90603-3042
Phone (562) 943-0211
Other practice location 2
1401 Brighton St
LA Habra, CA 90631-3201
Phone (562) 448-8217
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 Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30656 | CA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lowell Joint School District | Past | Accepting new patients | |
| Centra Pediatric Therapy | 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.
-
- Pediatric Occupational Therapist
- Tustin, CA
- NPI 1902177025
Speech-Language Pathologist
-
- Local Education Agency (LEA)
- Whittier, CA
- NPI 1497927909
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1602547200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602547200000",
"number": "1962000893",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1401 BRIGHTON ST",
"city": "LA HABRA",
"state": "CA",
"postal_code": "906313201",
"telephone_number": "562-448-8217"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3002 DOW AVE STE 114",
"city": "TUSTIN",
"state": "CA",
"postal_code": "927807247",
"telephone_number": "714-731-4668"
}
],
"practiceLocations": [
{
"address_1": "11019 Valley Home Ave",
"address_purpose": "LOCATION",
"city": "Whittier",
"state": "CA",
"postal_code": "906033042",
"country_code": "US",
"telephone_number": "562-943-0211",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1401 Brighton St",
"address_purpose": "LOCATION",
"city": "LA Habra",
"state": "CA",
"postal_code": "906313201",
"country_code": "US",
"telephone_number": "562-448-8217",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VAN VLIET",
"first_name": "RACHEL",
"middle_name": "N",
"credential": "M.S., CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-10-13",
"last_updated": "2020-10-13",
"certification_date": "2020-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "30656",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tustin, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.