Tina Debottari, MA CCC SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

21107 Issued in CA

Practice address

2768 Honeysuckle Way
Sacramento, CA 95826-3150

Phone

(916) 842-7574

NPI assigned

Jan 1, 2015

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)

Enrolled

Credentials

Master of Arts

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

{
    "created_epoch": "1420070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420070400000",
    "number": "1154719995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2768 HONEYSUCKLE WAY",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958263150",
            "telephone_number": "916-842-7574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2768 HONEYSUCKLE WAY",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958263150",
            "telephone_number": "916-842-7574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBOTTARI",
        "first_name": "TINA",
        "credential": "MA CCC SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-01",
        "last_updated": "2015-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "21107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Iosepa P Deberry
• Marquan Debise
• Dillon Ben Deboda
• Tricia Debone'
• Renee Aketch Debose, MD
• Debra J. Tripp, LMFT
• Debrah Deans Therapy
• Ahnalie Cata Debruyn
• Tyler Debuty
• Alfredo Decali

• Speech-Language Pathologist in Sacramento, CA
• Providers in Sacramento, 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 Jan 1, 2015; 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.