JONATHAN M WALLER MA CCC-SLP
NPI 1104351964
Speech-Language Pathologist in Los Angeles, CA

Active since April 28, 2017
92.26/100
CMS Quality Rating
1100 N STATE ST, CT A2E, LOS ANGELES, CA 90033(323) 409-5082 Get Directions Write a Review

NPPES record last updated: August 3, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Aug 3, 2020, Apr 28, 2017 (2 updates tracked since 2017).

About Jonathan M Waller Ma Ccc-slp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JONATHAN M WALLER MA CCC-SLP (NPI 1104351964) is an individual speech-language pathologist provider in Los Angeles, California, licensed in Georgia (SLP010930) and active in the NPI registry since April 2017.

NPPES Registry Identity

NPI1104351964
Entity TypeIndividualMale
Primary Taxonomy235Z00000X
Provider Legal NameJONATHAN M WALLERCredential: MA CCC-SLP
Location Address1100 N STATE ST, CT A2ELos Angeles, CA 90033-5000
Mailing Address1100 N State St, Ct A2eLos Angeles, CA 90033-5000 · (323) 409-5082
Sole ProprietorYes
Enumeration DateApril 28, 2017
Last NPPES UpdateAugust 3, 20202 updates tracked since enumeration
NPPES CertifiedAugust 3, 2020
NPI 1104351964 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySpeech-Language PathologistSpeech, Language and Hearing Service Providers
Taxonomy Code235Z00000X
Licenses Licensed in GA · SLP010930 Licensed in CA · 17522
Definition

The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing.

1100 N STATE ST, Los Angeles, CA 90033

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

92.26/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality73.83
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Social Worker (Clinical)
1100 N STATE ST
LOS ANGELES, CA 90033
Pediatrics
1100 N STATE ST, CLINIC TOWER, SUITE A7D
LOS ANGELES, CA 90033
Social Worker (Clinical)
1100 N STATE ST
LOS ANGELES, CA 90033
Registered Nurse (Ambulatory Care)
1100 N STATE ST
LOS ANGELES, CA 90033
Social Worker (Clinical)
1100 N STATE ST
LOS ANGELES, CA 90033
Social Worker (Clinical)
1100 N STATE ST
LOS ANGELES, CA 90033
General Acute Care Hospital
1100 N STATE ST, CLINIC TOWER A4E
LOS ANGELES, CA 90033
Registered Nurse (Ambulatory Care)
1100 N STATE ST
LOS ANGELES, CA 90033

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jonathan Waller's NPI number?

The NPI number for Jonathan Waller is 1104351964. It was assigned to this individual provider in the NPPES registry on April 28, 2017.

Where is Jonathan Waller located?

Jonathan Waller practices at 1100 N State St Ct A2e, Los Angeles, CA 90033. The listed phone number is (323) 409-5082.

What is Jonathan Waller's specialty?

The primary specialty registered for this NPI is Speech-Language Pathologist with taxonomy code 235Z00000X.

When was this NPI record last updated?

The NPPES record for Jonathan Waller was last updated on August 3, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.