Active NPI
Julie Manyak, MS, CCC
- Speech-Language Pathologist
- San Mateo, CA
National Provider Identifier
1124224605
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 12188
- Practice address
- 833 N Humboldt St Apt 309
San Mateo, CA 94401-1409 - Phone
- (650) 245-0069
- NPI assigned
- Jun 22, 2007
- Sex
- Female
- Sole proprietor
- No
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 | 12188 | CA | Primary |
Addresses
Primary practice location
833 N Humboldt St Apt 309
San Mateo, CA 94401-1409
Mailing address
833 N Humboldt St Apt 309
San Mateo, CA 94401-1409
Phone (650) 245-0069
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 Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12188 | CA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182470400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1360022400000",
"number": "1124224605",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "833 N HUMBOLDT ST APT 309",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "944011409",
"telephone_number": "650-245-0069"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "833 N HUMBOLDT ST APT 309",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "944011409",
"telephone_number": "650-245-0069"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANYAK",
"first_name": "JULIE",
"credential": "MS, CCC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-22",
"last_updated": "2013-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "12188",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Mateo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.