NPIMap

Individual provider Active NPI

Elisabeth Cheryl Fletcher, MA CCC

  • Speech-Language Pathologist
  • Camarillo, CA
National Provider Identifier
1225195183
Registry record updated Jun 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP 3002 Issued in CA
Practice address
150 Valley Vista Dr
Camarillo, CA 93010-1725
Phone
(805) 484-1671
Fax
(805) 987-0667
NPI assigned
Jan 2, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SP 3002 CA Primary
Behavior Analyst 103K00000X 1-11-8110
Early Intervention Provider Agency 252Y00000X

Addresses

Primary practice location

150 Valley Vista Dr
Camarillo, CA 93010-1725

Mailing address

150 Valley Vista Dr
Camarillo, CA 93010-1725
Phone (805) 484-1671

Other identifiers 1

IdentifierTypeStateIssuer
ZZZ83857ZOtherCABLUE SHIELD

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
SP 3002CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Therapy Services Inc. Behavior Analyst Past Accepting new patients
E. Cheryl Fletcher Speech Pathology & Associates Early Intervention Provider Agency Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371427200000",
    "number": "1225195183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 VALLEY VISTA DR",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930101725",
            "telephone_number": "805-484-1671",
            "fax_number": "805-987-0667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 VALLEY VISTA DR",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930101725",
            "telephone_number": "805-484-1671",
            "fax_number": "805-987-0667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLETCHER",
        "first_name": "ELISABETH",
        "middle_name": "CHERYL",
        "name_prefix": "Ms.",
        "credential": "MA CCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-02",
        "last_updated": "2013-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "SP 3002",
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-11-8110",
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ83857Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Camarillo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2013; 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.