Active NPI
Carly Bullard
- Speech-Language Pathologist
- Modesto, CA
National Provider Identifier
1194678250
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 12632
- Practice address
- 3101 Fine Ave
Modesto, CA 95355-9702 - Phone
- (209) 552-3200
- NPI assigned
- Feb 18, 2026
- 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 | 12632 | CA | Primary |
Addresses
Primary practice location
3101 Fine Ave
Modesto, CA 95355-9702
Mailing address
3101 Fine Ave
Modesto, CA 95355-9702
Phone (209) 552-3200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1771372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1771372800000",
"number": "1194678250",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3101 FINE AVE",
"city": "MODESTO",
"state": "CA",
"postal_code": "953559702",
"telephone_number": "209-552-3200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3101 FINE AVE",
"city": "MODESTO",
"state": "CA",
"postal_code": "953559702",
"telephone_number": "209-552-3200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BULLARD",
"first_name": "CARLY",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-02-18",
"last_updated": "2026-02-18",
"certification_date": "2026-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "12632",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Modesto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.