Individual provider Active NPI

Maria Momin, SLP., MA-CCC

  • Speech-Language Pathologist
  • San Jose, CA
National Provider Identifier
1013541952
Registry record updated Mar 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
18059 Issued in CA
Practice address
1033 S Daniel Way
San Jose, CA 95128-3124
Phone
(408) 324-4723
NPI assigned
Mar 1, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 18059 CA Primary

Addresses

Primary practice location

1033 S Daniel Way
San Jose, CA 95128-3124

Mailing address

1033 S Daniel Way
San Jose, CA 95128-3124
Phone (408) 324-4723

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

LicenseStateTypeSpecialty
18059CAMDSpeech-Language Pathologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1583020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583020800000",
    "number": "1013541952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1033 S DANIEL WAY",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951283124",
            "telephone_number": "408-324-4723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1033 S DANIEL WAY",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951283124",
            "telephone_number": "408-324-4723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOMIN",
        "first_name": "MARIA",
        "name_prefix": "Ms.",
        "credential": "SLP., MA-CCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-01",
        "last_updated": "2020-03-01",
        "certification_date": "2020-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "18059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.