Individual provider Active NPI

Bertha Gonzales Sesteaga, BACHELORS DEGREE

  • Speech-Language Pathologist
  • Tucson, AZ
National Provider Identifier
1073657276
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP0717 Issued in AZ
Practice address
1000 S Greasewood Rd
Tucson, AZ 85745-2571
Phone
(520) 225-3300
NPI assigned
Feb 19, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 SLP0717 AZ Primary

Addresses

Primary practice location

1000 S Greasewood Rd
Tucson, AZ 85745-2571

Mailing address

2307 W Horseshoe PL
Tucson, AZ 85745-1396
Phone (520) 622-2597

Other identifiers 1

IdentifierTypeStateIssuer
576605MedicaidAZ

Other names 1

  • Mrs. Bertha Navarro Sesteaga Former name

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
SLP0717AZMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073657276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2307 W HORSESHOE PL",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857451396",
            "telephone_number": "520-622-2597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 S GREASEWOOD RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857452571",
            "telephone_number": "520-225-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SESTEAGA",
        "first_name": "BERTHA",
        "middle_name": "GONZALES",
        "name_prefix": "Mrs.",
        "credential": "BACHELORS DEGREE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "SLP0717",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "576605",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BERTHA",
            "last_name": "SESTEAGA",
            "middle_name": "NAVARRO",
            "prefix": "MRS.",
            "credential": "BACHELORS DEGREE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.