Individual provider Active NPI

Bianca Lana Havel

  • Speech-Language Pathologist
  • San Rafael, CA
National Provider Identifier
1093191355
Registry record updated Aug 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
9998 Issued in CA
Practice address
232 Santa Margarita
San Rafael, CA 94901-1638
Phone
(415) 454-6340
NPI assigned
Aug 9, 2015
Last updated
Aug 9, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2015

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 9998 CA Primary

Addresses

Primary practice location

232 Santa Margarita
San Rafael, CA 94901-1638

Mailing address

232 Santa Margarita
San Rafael, CA 94901-1638
Phone (415) 454-6340

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
9998CAMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1439078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439078400000",
    "number": "1093191355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "232 SANTA MARGARITA",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949011638",
            "telephone_number": "415-454-6340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "232 SANTA MARGARITA",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949011638",
            "telephone_number": "415-454-6340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVEL",
        "first_name": "BIANCA",
        "middle_name": "LANA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-09",
        "last_updated": "2015-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "9998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Rafael, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2015; 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.