Active NPI
Deriah Raquel Cabico Medel
- Speech-Language Assistant
- Redondo Beach, CA
National Provider Identifier
1144757022
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Assistant
- License
- 3399
- Practice address
- 2850 Artesia Blvd Ste 107
Redondo Beach, CA 90278-3412 - Phone
- (424) 275-9968
- NPI assigned
- May 22, 2017
- 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 Assistant | 2355S0801X | 3399 | CA | Primary |
Addresses
Primary practice location
2850 Artesia Blvd Ste 107
Redondo Beach, CA 90278-3412
Mailing address
1200 S Neveen LN
Anaheim, CA 92804-4770
Phone (714) 348-8165
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 |
|---|---|---|---|
| 3399 | CA | MD | Speech-Language Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1495411200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1495411200000",
"number": "1144757022",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 S NEVEEN LN",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928044770",
"telephone_number": "714-348-8165"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2850 ARTESIA BLVD STE 107",
"city": "REDONDO BEACH",
"state": "CA",
"postal_code": "902783412",
"telephone_number": "424-275-9968"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDEL",
"first_name": "DERIAH",
"middle_name": "RAQUEL CABICO",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-05-22",
"last_updated": "2017-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "2355S0801X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Speech-Language Assistant",
"state": "CA",
"license": "3399",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redondo Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.