Active NPI
Nina Rose Coonerty, MA
- Speech-Language Pathologist
- Capitola, CA
National Provider Identifier
1336816404
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 15841
- Practice address
- 820 Bay Ave
Capitola, CA 95010-2140 - Phone
- (831) 854-2060
- NPI assigned
- Aug 26, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 Pathologist | 235Z00000X | 15841 | CA | Primary |
Addresses
Primary practice location
820 Bay Ave
Capitola, CA 95010-2140
Mailing address
119 Dimond St
Santa Cruz, CA 95060-3423
Phone (831) 419-2978
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
| License | State | Type | Specialty |
|---|---|---|---|
| 15841 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1629936000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629936000000",
"number": "1336816404",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "119 DIMOND ST",
"city": "SANTA CRUZ",
"state": "CA",
"postal_code": "950603423",
"telephone_number": "831-419-2978"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "820 BAY AVE",
"city": "CAPITOLA",
"state": "CA",
"postal_code": "950102140",
"telephone_number": "831-854-2060"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COONERTY",
"first_name": "NINA",
"middle_name": "ROSE",
"credential": "MA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-08-26",
"last_updated": "2021-08-26",
"certification_date": "2021-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "15841",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Capitola, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.