Kelly Rubolino, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

16676 Issued in CA

Practice address

30412 Esperanza
Rancho Santa Margarita, CA 92688-2144

Phone

(949) 459-1658

NPI assigned

Mar 31, 2011

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1301529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301529600000",
    "number": "1124317128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 CORTE TIERRA BELLA",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926736418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30412 ESPERANZA",
            "city": "RANCHO SANTA MARGARITA",
            "state": "CA",
            "postal_code": "926882144",
            "telephone_number": "949-459-1658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBOLINO",
        "first_name": "KELLY",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-31",
        "last_updated": "2011-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "16676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Rancho Santa Margarita, CA
• Providers in Rancho Santa Margarita, CA by specialty
• Speech-Language Pathologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2011; 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.