Katelyn Sellers, M.A., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

19962 Issued in CA

Practice address

4701 Patrick Henry Drive BLDG 23 Ste D
Santa Clara, CA 95054

Phone

(408) 807-6807

NPI assigned

Jun 20, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1403222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529798400000",
    "number": "1487069118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4701 PATRICK HENRY DR BLDG 23 STE D",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950541819",
            "telephone_number": "408-807-6807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4701 PATRICK HENRY DRIVE BLDG 23 STE D",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "95054",
            "telephone_number": "408-807-6807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELLERS",
        "first_name": "KATELYN",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-20",
        "last_updated": "2018-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "19962",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN SPEECH-LANGUAGE HEARING ASSOCIATION",
            "identifier": "14035572",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA SPEECH, LANGUAGE, AND HEARING AID DISPENSER'S BOARD",
            "identifier": "19962",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Santa Clara, CA
• Providers in Santa Clara, CA by specialty
• Speech-Language Pathologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2018; 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.