Active NPI
Rene Robles, SLP
- Speech-Language Pathologist
- Rancho Cucamonga, CA
National Provider Identifier
1174925960
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 10442
- Practice address
- 8265 White Oak Ave
Rancho Cucamonga, CA 91730-7671 - Phone
- (909) 373-1641
- NPI assigned
- Sep 23, 2014
- 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 | 10442 | CA | Primary |
Addresses
Primary practice location
8265 White Oak Ave
Rancho Cucamonga, CA 91730-7671
Mailing address
625 S Ditmar St
Oceanside, CA 92054-4141
Phone (909) 953-3714
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190415002786 | CA | Practitioner - Qualified Speech Language Pathologist | 3779873203 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1411430400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1451260800000",
"number": "1174925960",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "625 S DITMAR ST",
"city": "OCEANSIDE",
"state": "CA",
"postal_code": "920544141",
"telephone_number": "909-953-3714"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8265 WHITE OAK AVE",
"city": "RANCHO CUCAMONGA",
"state": "CA",
"postal_code": "917307671",
"telephone_number": "909-373-1641"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBLES",
"first_name": "RENE",
"name_prefix": "Mrs.",
"credential": "SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-09-23",
"last_updated": "2015-12-28",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "10442",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rancho Cucamonga, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.