Individual provider Active NPI

Tamara Lynn Backer, M.S. CCC-SLP

  • Speech-Language Pathologist
  • Oxnard, CA
National Provider Identifier
1457531618
Registry record updated Nov 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
11998 Issued in CA
Practice address
1546 Windshore Way
Oxnard, CA 93035-1401
Phone
(805) 822-9968
NPI assigned
Nov 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 11998 CA Primary

Addresses

Primary practice location

1546 Windshore Way
Oxnard, CA 93035-1401

Mailing address

1546 Windshore Way
Oxnard, CA 93035-1401
Phone (805) 822-9968

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091014000047 CA Practitioner - Qualified Speech Language Pathologist 6103962642 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Second Wave Physical Therapy IncGroup PAC ID 3274996905, 24 clinicians

Practice addresses (Care Compare)

721 W Channel Islands Blvd
Port Hueneme, CA 93041-2130
Phone (805) 250-7505

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
11998CAMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Two Trees Physical Therapy & Wellness Inc CurrentSince Jun 17, 2013 Accepting new patients
Second Wave Physical Therapy Inc. CurrentSince Aug 1, 2023 Accepting new patients
Two Trees Physical Therapy & Wellness Inc Speech-Language Pathologist CurrentSince Jun 17, 2013 Accepting new patients
Bridge Communication Speech/Language Pathologists Speech-Language Pathologist Past Accepting new patients
The Oaks Physical Therapists and Rehabilitation Specialists, Inc. Past Accepting new patients

Locations

552 Sespe Ave
Fillmore, CA 93015
Phone (805) 242-4575

735 W Channel Islands Blvd
Port Hueneme, CA 93041
Phone (805) 250-7505

721 W Channel Islands Blvd
Port Hueneme, CA 93041
Phone (805) 250-7505

3418 Loma Vista Rd
Ste A
Ventura, CA 93003
Phone (805) 642-8565

801 S Victoria Ave
Ventura, CA 93003
Phone (805) 250-7505

Organizations & group practices 5

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1194220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353369600000",
    "number": "1457531618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1546 WINDSHORE WAY",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930351401",
            "telephone_number": "805-822-9968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1546 WINDSHORE WAY",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930351401",
            "telephone_number": "805-822-9968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACKER",
        "first_name": "TAMARA",
        "middle_name": "LYNN",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-05",
        "last_updated": "2012-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "11998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxnard, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2012; 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.

Verify at the official NPI Registry.