Individual provider Active NPI

Cassandra Sierra

  • Speech-Language Assistant
  • Tracy, CA
National Provider Identifier
1477079655
Registry record updated Sep 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
3716 Issued in CA
Practice address
632 W 11TH St Ste 119
Tracy, CA 95376
Phone
(925) 470-6948
NPI assigned
Aug 18, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Speech-Language Assistant 2355S0801X 3716 CA Primary

Addresses

Primary practice location

632 W 11TH St Ste 119
Tracy, CA 95376

Mailing address

632 W 11TH St Ste 119
Tracy, CA 95376-3860
Phone (925) 470-6948

Other practice location 1

1500 S. Ave. K
Station 3 SHROC
Portales, NM 88130
Phone (575) 562-4232

Other practice location 2

1500 S. Ave. K
Station 3 SHROC
Portales, NM 88130
Phone (575) 562-4232

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

LicenseStateTypeSpecialty
3716CAMDSpeech-Language Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Eastern New Mexico University PastSince Nov 12, 2023 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1503014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569628800000",
    "number": "1477079655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "632 W 11TH ST STE 119",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953763860",
            "telephone_number": "925-470-6948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "632 W 11TH ST STE 119",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "95376",
            "telephone_number": "925-470-6948"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 S. Ave. K",
            "address_2": "Station 3 SHROC",
            "address_purpose": "LOCATION",
            "city": "Portales",
            "state": "NM",
            "postal_code": "88130",
            "country_code": "US",
            "telephone_number": "575-562-4232",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1500 S. Ave. K",
            "address_2": "Station 3 SHROC",
            "address_purpose": "LOCATION",
            "city": "Portales",
            "state": "NM",
            "postal_code": "88130",
            "country_code": "US",
            "telephone_number": "575-562-4232",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIERRA",
        "first_name": "CASSANDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-18",
        "last_updated": "2019-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "CA",
            "license": "3716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tracy, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 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.

Verify at the official NPI Registry.