Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mimi Park, MS, CCC-SLP

Individual provider Speech-Language Pathologist · NPI 1669132213

Mimi Park, MS, CCC-SLP is a Speech-Language Pathologist in Menlo Park, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2021
What do these letters mean?
MS — Master of Science
A graduate science degree.
CCC-SLP — Certificate of Clinical Competence in Speech-Language Pathology
A speech-language pathologist certified by ASHA.

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Practice location Address checks out

648 Menlo Ave Ste 8
Menlo Park, CA 94025-4713
Phone: (650) 714-9459
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X · Licence 19011 (CA)

Record details

NPI number1669132213
Entity typeIndividual (Type 1)
GenderFemale
Credentials MS , CCC-SLP
Sole proprietorYes
NPI enumeratedDecember 22, 2021
Last updated in NPPESDecember 22, 2021
Certification dateDecember 22, 2021
Mailing address648 Menlo Ave Ste 8, Menlo Park, CA 94025-4713

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