Active NPI
Victoria Rivera
- Speech-Language Assistant
- Surprise, AZ
National Provider Identifier
1366074064
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Assistant
- License
- 12257
- Practice address
- 26934 N 178TH Ave
Surprise, AZ 85387-1075 - Phone
- (623) 980-4164
- NPI assigned
- Feb 10, 2020
- 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 | 12257 | AZ | Primary |
Addresses
Primary practice location
26934 N 178TH Ave
Surprise, AZ 85387-1075
Mailing address
12030 N 62ND Dr
Glendale, AZ 85304-2537
Phone (602) 881-7190
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 |
|---|---|---|---|
| 12257 | AZ | MD | Speech-Language Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Therapy Builders, LLC | Speech-Language Assistant | 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 and National Provider Directory roles.
-
- Speech-Language Pathologist
- Surprise, AZ
- NPI 1942735246
Speech-Language Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1581292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1581292800000",
"number": "1366074064",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12030 N 62ND DR",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853042537",
"telephone_number": "602-881-7190"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26934 N 178TH AVE",
"city": "SURPRISE",
"state": "AZ",
"postal_code": "853871075",
"telephone_number": "623-980-4164"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIVERA",
"first_name": "VICTORIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-02-10",
"last_updated": "2020-02-10",
"certification_date": "2020-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "2355S0801X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Speech-Language Assistant",
"state": "AZ",
"license": "12257",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Surprise, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.