Individual provider Active NPI

Mitra Ahani, M.S

  • Speech-Language Pathologist
  • San Mateo, CA
National Provider Identifier
1265660617
Registry record updated Jun 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
13446 Issued in CA
Practice address
127 N San Mateo Dr
2ND Floor
San Mateo, CA 94401-2708
Phone
(650) 548-1110
NPI assigned
Jun 24, 2009
Sex
Female
Sole proprietor
No

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 Science

State licenses

LicenseStateTypeSpecialty
13446CAMDSpeech-Language Pathologist

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 13446 CA Primary

Addresses

NPPES NPI Registry

Primary practice location

127 N San Mateo Dr
2ND Floor
San Mateo, CA 94401-2708

Mailing address

127 N San Mateo Dr
2ND Floor
San Mateo, CA 94401-2708
Phone (650) 548-1110

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 24, 2009.

{
    "created_epoch": "1245801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245801600000",
    "number": "1265660617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 N SAN MATEO DR",
            "address_2": "2ND FLOOR",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944012708",
            "telephone_number": "650-548-1110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 N SAN MATEO DR",
            "address_2": "2ND FLOOR",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944012708",
            "telephone_number": "650-548-1110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHANI",
        "first_name": "MITRA",
        "credential": "M.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-24",
        "last_updated": "2009-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "13446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Mateo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2009; 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.