Active NPI
Lizeth Mata
- Speech-Language Pathologist
- Rio Rancho, NM
National Provider Identifier
1467753145
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- C-4817
- Practice address
- 7112 Kalgan Rd NE
Rio Rancho, NM 87144-3532 - Phone
- (505) 307-3234
- NPI assigned
- Nov 10, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | C-4817 | NM | Primary |
Addresses
Primary practice location
7112 Kalgan Rd NE
Rio Rancho, NM 87144-3532
Mailing address
7112 Kalgan Rd NE
Rio Rancho, NM 87144-3532
Phone (505) 307-3234
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 |
|---|---|---|---|
| C-4817 | NM | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1289347200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1559692800000",
"number": "1467753145",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7112 KALGAN RD NE",
"city": "RIO RANCHO",
"state": "NM",
"postal_code": "871443532",
"telephone_number": "505-307-3234"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7112 KALGAN RD NE",
"city": "RIO RANCHO",
"state": "NM",
"postal_code": "871443532",
"telephone_number": "505-307-3234"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATA",
"first_name": "LIZETH",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-11-10",
"last_updated": "2019-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NM",
"license": "C-4817",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rio Rancho, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.