Alexis Jordan Bringolf

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

30720 Issued in CA

Practice address

3498 Green Valley Rd
Rescue, CA 95672-9625

Phone

(530) 391-8670

NPI assigned

Sep 25, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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": "1600992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600992000000",
    "number": "1144837956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4125 CARLSON CT",
            "city": "SHINGLE SPRINGS",
            "state": "CA",
            "postal_code": "956828742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3498 GREEN VALLEY RD",
            "city": "RESCUE",
            "state": "CA",
            "postal_code": "956729625",
            "telephone_number": "530-391-8670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRINGOLF",
        "first_name": "ALEXIS",
        "middle_name": "JORDAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-25",
        "last_updated": "2020-09-25",
        "certification_date": "2020-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "30720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "abringolf@ghcot.com",
            "affiliation": "N",
            "endpointDescription": "Work email",
            "address_1": "3498 Green Valley Rd",
            "city": "Rescue",
            "state": "CA",
            "country_code": "US",
            "postal_code": "956729625",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Veronica Bernal
• Debra Bjorklund, RN
• Maryann Bloomquist
• Zoe Boyer, COTA
• Wendy Lynne Brandt, COTA
• McKenzie Brown
• Douglas Jonathan Burland, RAS
• Morgan Butler
• Corrin R Campbell, COTA
• Samantha Capezzuto, MOT, OTR/L

• Speech-Language Pathologist in Rescue, CA
• Providers in Rescue, 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 Sep 25, 2020; 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.