Active NPI
Lisa Anne Moreno, SLPA
- Speech-Language Assistant
- Moreno Valley, CA
National Provider Identifier
1962846105
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Assistant
- License
- 426
- Practice address
- 11650 Perris Blvd
Moreno Valley, CA 92557-6536 - Phone
- (951) 488-0404
- NPI assigned
- Apr 18, 2013
- 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 Assistant | 2355S0801X | 426 | CA | Primary |
Addresses
Primary practice location
11650 Perris Blvd
Moreno Valley, CA 92557-6536
Mailing address
11650 Perris Blvd
Moreno Valley, CA 92557-6536
Phone (951) 488-0404
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
| License | State | Type | Specialty |
|---|---|---|---|
| 426 | CA | MD | Speech-Language Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1366243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1366243200000",
"number": "1962846105",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11650 PERRIS BLVD",
"city": "MORENO VALLEY",
"state": "CA",
"postal_code": "925576536",
"telephone_number": "951-488-0404"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11650 PERRIS BLVD",
"city": "MORENO VALLEY",
"state": "CA",
"postal_code": "925576536",
"telephone_number": "951-488-0404"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORENO",
"first_name": "LISA",
"middle_name": "ANNE",
"credential": "SLPA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-04-18",
"last_updated": "2013-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "2355S0801X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Speech-Language Assistant",
"state": "CA",
"license": "426",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moreno Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.