Individual provider Active NPI

Lynn Keiko Nishikawa, S.P.L.

  • Speech-Language Pathologist
  • Riverside, CA
National Provider Identifier
1033207188
Registry record updated Feb 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SPL 4022 Issued in CA
Practice address
6177 River Crest Dr Ste a
Riverside, CA 92507-0728
Phone
(951) 653-4480
Fax
(951) 653-5051
NPI assigned
Oct 11, 2006
Last updated
Feb 2, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2009

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 SPL 4022 CA Primary

Addresses

Primary practice location

6177 River Crest Dr Ste a
Riverside, CA 92507-0728

Mailing address

6177 River Crest Dr Ste a
Riverside, CA 92507-0728
Phone (951) 653-4480

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121031000325 CA Practitioner - Qualified Speech Language Pathologist 2163672056 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Coast Spine Restoration Center IncGroup PAC ID 7214824648, 19 clinicians

Practice addresses (Care Compare)

6177 River Crest Dr
Suite a
Riverside, CA 92507-0728
Phone (951) 653-4480

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SPL 4022CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
West Coast Spine Restoration Center, Inc Speech-Language Pathologist CurrentSince Oct 1, 2012 Accepting new patients

Locations

6177 River Crest Dr
Ste A
Riverside, CA 92507
Phone (951) 653-4480

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233532800000",
    "number": "1033207188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6177 RIVER CREST DR STE A",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925070728",
            "telephone_number": "951-653-4480",
            "fax_number": "951-653-5051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6177 RIVER CREST DR STE A",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925070728",
            "telephone_number": "951-653-4480",
            "fax_number": "951-653-5051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NISHIKAWA",
        "first_name": "LYNN",
        "middle_name": "KEIKO",
        "credential": "S.P.L.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2009-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "SPL 4022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.