Active NPI
Alejandra Pedroza
- Speech-Language Assistant
- Antioch, CA
National Provider Identifier
1336614668
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Assistant
- License
- 5001
- Practice address
- 700 W 18TH St
Antioch, CA 94509-1500 - Phone
- (925) 779-7550
- NPI assigned
- Oct 13, 2018
- Last updated
- Oct 13, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Assistant | 2355S0801X | 5001 | CA | Primary |
Addresses
Primary practice location
700 W 18TH St
Antioch, CA 94509-1500
Mailing address
29516 Kohoutek Way
Union City, CA 94587-1221
Phone (510) 362-0827
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5001 | CA | MD | Occupational Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fred Finch Youth Center | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Antioch High School
- Community/Behavioral Health Agency
- Antioch, CA
- NPI 1275425035
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1539388800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1539388800000",
"number": "1336614668",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29516 KOHOUTEK WAY",
"city": "UNION CITY",
"state": "CA",
"postal_code": "945871221",
"telephone_number": "510-362-0827"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 W 18TH ST",
"city": "ANTIOCH",
"state": "CA",
"postal_code": "945091500",
"telephone_number": "925-779-7550"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEDROZA",
"first_name": "ALEJANDRA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-10-13",
"last_updated": "2018-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "2355S0801X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Speech-Language Assistant",
"state": "CA",
"license": "5001",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Antioch, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.