Audrey Mahlstedt, MA CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

18299 Issued in CA

Practice address

7165 Burton Ave
Rohnert Park, CA 94928-3316

Phone

(707) 792-4700

NPI assigned

Apr 25, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Audrey Harrington Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Cotati-Rohnert Park Unified School District

  • Local Education Agency (LEA)
  • Rohnert Park, CA
  • NPI 1871796748
  NPD (past)

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

{
    "created_epoch": "1556150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556150400000",
    "number": "1164086187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2186 FRANCISCO AVE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954038173",
            "telephone_number": "760-390-5450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7165 BURTON AVE",
            "city": "ROHNERT PARK",
            "state": "CA",
            "postal_code": "949283316",
            "telephone_number": "707-792-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHLSTEDT",
        "first_name": "AUDREY",
        "credential": "MA CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-25",
        "last_updated": "2019-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-16-21486",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "18299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AUDREY",
            "last_name": "HARRINGTON",
            "credential": "MA CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lyndsey Rose Lynch
• Elyse Mager, BCBA
• Michael D. Maggioncalda, DO
• Joshua A Magly
• Venus Ann Maher, D.C.
• Leah Mahood
• George Malkemus, DDS
• John D Mann, DDS
• Kavita Mardemootoo
• Marin Wellness Pharmacy LLC

• Speech-Language Pathologist in Rohnert Park, CA
• Providers in Rohnert Park, 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 Apr 25, 2019; 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.