Active NPI
Radiance Barber
- Speech-Language Assistant
- Roseville, CA
National Provider Identifier
1376046078
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Assistant
- License
- 5576
- Practice address
- 730 Sunrise Ave Ste 120
Roseville, CA 95661-4549 - Phone
- (916) 436-8687
- NPI assigned
- Mar 9, 2018
- 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 Assistant | 2355S0801X | 5576 | CA | Primary |
Addresses
Primary practice location
730 Sunrise Ave Ste 120
Roseville, CA 95661-4549
Mailing address
1541 Falabella Way
Olivehurst, CA 95961-4915
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| E1192437 | Medicaid | CA |
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 |
|---|---|---|---|
| 5576 | CA | MD | Speech-Language Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1520553600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704758400000",
"number": "1376046078",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1541 FALABELLA WAY",
"city": "OLIVEHURST",
"state": "CA",
"postal_code": "959614915"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "730 SUNRISE AVE STE 120",
"city": "ROSEVILLE",
"state": "CA",
"postal_code": "956614549",
"telephone_number": "916-436-8687"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BARBER",
"first_name": "RADIANCE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-03-09",
"last_updated": "2024-01-09",
"certification_date": "2024-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "2355S0801X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Speech-Language Assistant",
"state": "CA",
"license": "5576",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "E1192437",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Roseville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.