Individual provider Active NPI

Shelley Guidi, SLP-CCC

  • Speech-Language Pathologist
  • San Rafael, CA
National Provider Identifier
1205955382
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP 14360 Issued in CA
Practice address
30 N San Pedro Rd Ste 265
San Rafael, CA 94903-4153
Phone
(415) 479-7880
Fax
(415) 479-7889
NPI assigned
Mar 28, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SP 14360 CA Primary

Addresses

Primary practice location

30 N San Pedro Rd Ste 265
San Rafael, CA 94903-4153

Mailing address

1 Corte Dorado
Greenbrae, CA 94904-1112
Phone (415) 479-7880

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

State licenses

LicenseStateTypeSpecialty
SP 14360CAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205955382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CORTE DORADO",
            "city": "GREENBRAE",
            "state": "CA",
            "postal_code": "949041112",
            "telephone_number": "415-479-7880",
            "fax_number": "415-479-7889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 N SAN PEDRO RD STE 265",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949034153",
            "telephone_number": "415-479-7880",
            "fax_number": "415-479-7889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUIDI",
        "first_name": "SHELLEY",
        "credential": "SLP-CCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "SP 14360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Rafael, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.