NPIMap

Organization Active NPI

Speech Therapy Marin

  • Speech-Language Pathologist
  • Mill Valley, CA
National Provider Identifier
1205338332
Registry record updated Mar 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
16970 Issued in CA
Legal business name
SPEECH THERAPY MARIN
Doing business as
Child Development Center of Marin
Speech, Marin
Practice address
1058 Redwood Hwy Frontage Rd Ste a
Mill Valley, CA 94941-1660
Phone
(415) 924-2444
Fax
(415) 924-2442
NPI assigned
Mar 5, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2024

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

Authorized official

Name
Denise Santos Ford, CCC - SLP
Title
SLP
Phone
(415) 924-2444

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X 16970 CA Primary

Addresses

Primary practice location

1058 Redwood Hwy Frontage Rd Ste a
Mill Valley, CA 94941-1660

Mailing address

1058 Redwood Hwy Frontage Rd Ste a
Mill Valley, CA 94941-1660
Phone (415) 924-2444

Other names 2

  • Child Development Center of Marin Doing business as
  • Speech, Marin Doing business as

National Provider Directory

National Provider Directory

Locations

645 Tamalpais Dr
Ste B
Corte Madera, CA 94925
Phone (415) 924-2444

1058 Redwood Hwy Frontage Rd
Ste A
Mill Valley, CA 94941
Phone (415) 924-2444

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1520208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709683200000",
    "number": "1205338332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1058 REDWOOD HWY FRONTAGE RD STE A",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "949411660",
            "telephone_number": "415-924-2444",
            "fax_number": "415-924-2442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1058 REDWOOD HWY FRONTAGE RD STE A",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "949411660",
            "telephone_number": "415-924-2444",
            "fax_number": "415-924-2442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPEECH THERAPY MARIN",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-05",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A",
        "authorized_official_last_name": "FORD",
        "authorized_official_first_name": "DENISE",
        "authorized_official_middle_name": "SANTOS",
        "authorized_official_title_or_position": "SLP",
        "authorized_official_telephone_number": "415-924-2444",
        "authorized_official_credential": "CCC - SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "16970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Child Development Center of Marin",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Speech, Marin",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Speech, Marin",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mill Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2024; 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.