Ivonne De Carlo Fuller, M.S
NPI 1679859631ActiveIndividual· Speech-Language Pathologist· Baldwin Park, CA
Speech-Language Pathologist (M.S) in Baldwin Park, California, licensed in CA, with an NPI issued in October 2011. Enrolled in Medicare as practitioner - qualified speech language pathologist.
Overview
| NPI | 1679859631 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | M.S |
| Sole proprietor | No |
| NPI issued | Oct 21, 2011 |
| Last updated in NPPES | Dec 16, 2021 |
| Certified by provider | Dec 16, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Speech-Language Pathologist Primary | 235Z00000X | 20326 | CA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Qualified Speech Language Pathologist (CA) |
|---|
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