Juan Pablo Herrera Obaldo, SLPA

Primary specialty

Speech-Language AssistantTaxonomy code 2355S0801X

License

5677 Issued in CA

Practice address

632 W 11TH St Ste 119
Tracy, CA 95376-3860

Phone

(209) 237-2484

Fax

(209) 237-2485

NPI assigned

Mar 21, 2025

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1742515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742515200000",
    "number": "1285435560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "632 W 11TH ST STE 119",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953763860",
            "telephone_number": "209-237-2484",
            "fax_number": "209-237-2485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "632 W 11TH ST STE 119",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953763860",
            "telephone_number": "209-237-2484",
            "fax_number": "209-237-2485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBALDO",
        "first_name": "JUAN PABLO",
        "middle_name": "HERRERA",
        "credential": "SLPA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-03-21",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "CA",
            "license": "5677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Assistant in Tracy, CA
• Providers in Tracy, CA by specialty
• Speech-Language Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2025; 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.