Individual provider Active NPI

Mackenzie Zoller

  • Speech-Language Pathologist
  • Salinas, CA
National Provider Identifier
1073045290
Registry record updated Dec 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
14400 Issued in CA
Practice address
637 E Romie LN
Salinas, CA 93901-4205
Phone
(831) 424-0687
NPI assigned
Mar 28, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2023

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 14400 CA Primary

Addresses

Primary practice location

637 E Romie LN
Salinas, CA 93901-4205

Mailing address

2600 Compass Rd
Glenview, IL 60026-8001

Other practice location 1

102 S Tejon St Ste 1100
Colorado Springs, CO 80903-2253
Phone (512) 399-0064

Other practice location 2

633 W 5th St Ofc 2876B
Los Angeles, CA 90071-2005
Phone (512) 399-0064

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20231212002363 CO Practitioner - Qualified Speech Language Pathologist 1759730047 Reassigns benefits to 1 organization
I20231222001291 CA Practitioner - Qualified Speech Language Pathologist 1759730047 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14400CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Expressable Speech-Language Pathology, P.C. Speech-Language Pathologist CurrentSince Dec 18, 2023 Accepting new patients
Expressable Therapy PC Speech-Language Pathologist CurrentSince Dec 18, 2023 Accepting new patients
Sand Coast Rehab Physical Therapy Inc Speech-Language Pathologist CurrentSince May 1, 2025 Accepting new patients

Locations

633 W 5th St
Ste 2876B
Los Angeles, CA 90071

633 W 5th St
Ofc 2876B
Los Angeles, CA 90071

551 Gibson Ave
Pacific Grove, CA 93950
Phone (831) 242-8394

3558 Round Barn Blvd
Ste 600
Santa Rosa, CA 95403

102 S Tejon St
Ste 1100
Colorado Springs, CO 80903
Phone (514) 851-3224

7600 Chevy Chase Dr
Ste 300
Austin, TX 78752
Phone (512) 318-2503

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1490659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702857600000",
    "number": "1073045290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 COMPASS RD",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600268001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "637 E ROMIE LN",
            "city": "SALINAS",
            "state": "CA",
            "postal_code": "939014205",
            "telephone_number": "831-424-0687"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "102 S Tejon St Ste 1100",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809032253",
            "country_code": "US",
            "telephone_number": "512-399-0064",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "633 W 5th St Ofc 2876B",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900712005",
            "country_code": "US",
            "telephone_number": "512-399-0064",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZOLLER",
        "first_name": "MACKENZIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-28",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "14400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salinas, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.