Active NPI
Leah Wondrak, SLP
- Speech-Language Pathologist
- Dixon, CA
National Provider Identifier
1417262262
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SP28956
- Practice address
- 255 N Lincoln St Ste a
Dixon, CA 95620-3238 - Phone
- (707) 366-5247
- NPI assigned
- Aug 17, 2010
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SP.9817 | OH | |
| Speech-Language Pathologist | 235Z00000X | SP28956 | CA | Primary |
Addresses
Primary practice location
255 N Lincoln St Ste a
Dixon, CA 95620-3238
Mailing address
255 N Lincoln St Ste a
Dixon, CA 95620-3238
Phone (707) 366-5246
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0028740 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Qualified Speech Language Pathologist
- Education
- Other, 2009
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
2500 Metrohealth Dr
Cleveland, OH 44109-1900
2500 Metrohealth Dr
Cleveland, OH 44109-1998
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP28956 | CA | MD | Speech-Language Pathologist |
| SP.9817 | OH | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Speech Therapy Consulting, Inc. | Speech-Language Pathologist | Current | Accepting new patients |
Locations
255 N Lincoln St
Ste A
Dixon, CA 95620
Phone (530) 591-3859
Organizations & group practices 2
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.
-
dba Metrohealth Professional Group
- Multi-Specialty Clinic/Center
- Cleveland, OH
- NPI 1053353896
-
- Speech-Language Pathologist
- Dixon, CA
- NPI 1730702804
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1282003200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1682035200000",
"number": "1417262262",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "255 N LINCOLN ST STE A",
"city": "DIXON",
"state": "CA",
"postal_code": "956203238",
"telephone_number": "707-366-5246"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "255 N LINCOLN ST STE A",
"city": "DIXON",
"state": "CA",
"postal_code": "956203238",
"telephone_number": "707-366-5247"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WONDRAK",
"first_name": "LEAH",
"credential": "SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-08-17",
"last_updated": "2023-04-21",
"certification_date": "2023-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "OH",
"license": "SP.9817",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "SP28956",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0028740",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Dixon, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.