NPI Code Detail JSON Logo

1609273234 NPI number — PROGRESS SPEECH & LANGUAGE PATHOLOGY CENTER, INC.

NPI Number: 1609273234
Health Care Provider/Practitioner: PROGRESS SPEECH & LANGUAGE PATHOLOGY CENTER, INC.

Information about “1609273234” NPI (PROGRESS SPEECH & LANGUAGE PATHOLOGY CENTER, INC.) exists in 1609273234 in HTML format HTML  |  1609273234 in plain Text format TXT  |  1609273234 in PDF (Portable Document Format) PDF  |  1609273234 in an XML format XML  formats.

NPI Number : 1609273234 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1609273234",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "PROGRESS SPEECH & LANGUAGE PATHOLOGY CENTER, INC.",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "304 W CERRITOS AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "ANAHEIM",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "92805-6550",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "714-533-1230",
    "MailingAddressFaxNumber": "714-533-1232",
    "FirstLinePracticeLocationAddress": "304 W CERRITOS AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "ANAHEIM",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "92805-6550",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "714-533-1230",
    "PracticeLocationAddressFaxNumber": "714-533-1232",
    "EnumerationDate": "11/25/2014",
    "LastUpdateDate": "11/25/2014",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "JEONG",
    "AuthorizedOfficialFirstName": "PETER",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "OFFICE MANAGER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "714-533-1230",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "225100000X",
          "TaxonomyName": "Physical Therapist",
          "LicenseNumber": "PT40121",
          "LicenseNumberStateCode": "CA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "225X00000X",
          "TaxonomyName": "Occupational Therapist",
          "LicenseNumber": "OT14047",
          "LicenseNumberStateCode": "CA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "235Z00000X",
          "TaxonomyName": "Speech-Language Pathologist",
          "LicenseNumber": "SP12464",
          "LicenseNumberStateCode": "CA",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        }
      ]
    }
  }
}
                
            

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