Active NPI
Maren Crickmore Thacker, MA, CCC-SLP
- Speech-Language Pathologist
- San Diego, CA
National Provider Identifier
1366895856
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 15412
- Practice address
- 10877 Caminito Arcada
San Diego, CA 92131-3666 - Phone
- (858) 231-6039
- NPI assigned
- Jul 20, 2016
- Last updated
- Jul 20, 2016
- 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 | 15412 | CA | Primary |
Addresses
Primary practice location
10877 Caminito Arcada
San Diego, CA 92131-3666
Mailing address
10877 Caminito Arcada
San Diego, CA 92131-3666
Phone (858) 231-6039
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| RL Speech Therapy, Apc | Speech-Language Pathologist | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1468972800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1468972800000",
"number": "1366895856",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10877 CAMINITO ARCADA",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921313666",
"telephone_number": "858-231-6039"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10877 CAMINITO ARCADA",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921313666",
"telephone_number": "858-231-6039"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THACKER",
"first_name": "MAREN",
"middle_name": "CRICKMORE",
"credential": "MA, CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-07-20",
"last_updated": "2016-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "15412",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.