Active NPI
Manjiri Patkar
- Speech-Language Pathologist
- Redding, CA
National Provider Identifier
1124363288
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SP 18078
- Practice address
- 2516 Goodwater Ave
Suite B
Redding, CA 96002-1559 - Phone
- (530) 242-1511
- NPI assigned
- Nov 30, 2012
- 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 | SP 18078 | CA | Primary |
Addresses
Primary practice location
2516 Goodwater Ave
Suite B
Redding, CA 96002-1559
Mailing address
2701 N Rocky Point Dr
Suite 650
Tampa, FL 33607-5917
Phone (530) 242-1511
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
| License | State | Type | Specialty |
|---|---|---|---|
| SP 18078 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1354233600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1354233600000",
"number": "1124363288",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2701 N ROCKY POINT DR",
"address_2": "SUITE 650",
"city": "TAMPA",
"state": "FL",
"postal_code": "336075917",
"telephone_number": "530-242-1511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2516 GOODWATER AVE",
"address_2": "SUITE B",
"city": "REDDING",
"state": "CA",
"postal_code": "960021559",
"telephone_number": "530-242-1511"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATKAR",
"first_name": "MANJIRI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-11-30",
"last_updated": "2012-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "SP 18078",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redding, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.