Active NPI
Cassandra Sierra
- Speech-Language Assistant
- Tracy, CA
National Provider Identifier
1477079655
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Assistant
- License
- 3716
- 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
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 |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 3716 | CA | MD | Speech-Language Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eastern New Mexico University | Past | 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.
-
- Speech-Language Pathologist
- Portales, NM
- NPI 1356115273
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.