Active NPI
Carla Anne Cipollone, MA
- Speech-Language Pathologist
- Grass Valley, CA
National Provider Identifier
1023609559
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 11300
- Practice address
- 11551 Squirrel Creek Rd
Grass Valley, CA 95945-4644 - Phone
- (530) 559-7095
- NPI assigned
- Jan 28, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 11300 | CA | Primary |
Addresses
Primary practice location
11551 Squirrel Creek Rd
Grass Valley, CA 95945-4644
Mailing address
11551 Squirrel Creek Rd
Grass Valley, CA 95945-4644
Phone (530) 559-7095
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11300 | Other | CA | STATE OF CALIFORNIA DEPARTMENT OF CONSUMER AFFAIRS |
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11300 | CA | MD | Orthopedic Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1611792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611792000000",
"number": "1023609559",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11551 SQUIRREL CREEK RD",
"city": "GRASS VALLEY",
"state": "CA",
"postal_code": "959454644",
"telephone_number": "530-559-7095"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11551 SQUIRREL CREEK RD",
"city": "GRASS VALLEY",
"state": "CA",
"postal_code": "959454644",
"telephone_number": "530-559-7095"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CIPOLLONE",
"first_name": "CARLA",
"middle_name": "ANNE",
"name_prefix": "Ms.",
"credential": "MA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-01-28",
"last_updated": "2021-01-28",
"certification_date": "2021-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "11300",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF CALIFORNIA DEPARTMENT OF CONSUMER AFFAIRS",
"identifier": "11300",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Grass Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.