Cheryl Larson, M.A., CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · Glen Ellen, CA
NPI 1184037814 · NPPES record last updated Jun 10, 2014
Key facts
- NPI
- 1184037814
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 10017 (CA)
- Practice address
- 10754 Hwy 12
Glen Ellen, CA 95442-9784 - Phone
- (707) 235-3752
- NPI assigned
- Jun 10, 2014
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 7
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NV
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20181104000031 | NV | Practitioner - Qualified Speech Language Pathologist | 9537412820 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10017 | CA | MD | Acupuncturist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Care Services LLC | Current |
Accepting new patients | |
| Community Care Services LLC | Current |
Accepting new patients | |
| Renown Medical School Associates North, Inc. | Speech-Language Pathologist | Current |
Accepting new patients |
| Renown Medical School Associates North, Inc. | Current | Accepting new patients | |
| Community Care Services LLC | Current | Accepting new patients | |
| Renown Medical School Associates North, Inc. | Current |
Accepting new patients | |
| Community Care Services LLC | Past | Accepting new patients |
Locations
5190 Neil Rd
Ste 215
Reno, NV 89502
Phone (775) 784-4917
1664 N Virginia St
Reno, NV 89503
Phone (775) 982-1000
1664 N Virginia St
Reno, NV 89557
Phone (775) 784-1110
10315 Professional Cir
Reno, NV 89521
Phone (775) 982-5860
1664 N Virginia St
Stop 1332
Reno, NV 89557
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 10017 | CA | Yes |
Addresses
Primary practice location
10754 Hwy 12
Glen Ellen, CA 95442-9784
Mailing address
PO Box 244
Kenwood, CA 95452-0244
Phone (707) 235-3752
Other providers in Glen Ellen, CA
- Jonathan Alan Brouillard
- Justine Carandang
- Angie Denbeste
- Claire Gallagher
- Ann Elizabeth Kottler
- Cathleen Leonard
- McCoy'S Helping Hands
- New Vista Recovery, Inc.
- Tadashi Nitasaka
- Kaitlyn Pintor
All providers in Glen Ellen, CA · Speech-Language Pathologist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 10, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.