Individual provider Active NPI

Vicky L Hermreck, MA, CCC-SLP

  • Speech-Language Pathologist
  • Modesto, CA
National Provider Identifier
1538427539
Registry record updated Apr 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
12834 Issued in CA
Practice address
3220 Coho Dr
Modesto, CA 95355-7903
Phone
(209) 505-8321
Fax
(209) 551-5407
NPI assigned
Apr 26, 2012
Last updated
Apr 26, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 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 12834 CA Primary

Addresses

Primary practice location

3220 Coho Dr
Modesto, CA 95355-7903

Mailing address

3220 Coho Dr
Modesto, CA 95355-7903
Phone (209) 505-8321

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
Credentials
Master of Arts

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1335398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335398400000",
    "number": "1538427539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3220 COHO DR",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953557903",
            "telephone_number": "209-505-8321",
            "fax_number": "209-551-5407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3220 COHO DR",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953557903",
            "telephone_number": "209-505-8321",
            "fax_number": "209-551-5407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERMRECK",
        "first_name": "VICKY",
        "middle_name": "L",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-26",
        "last_updated": "2012-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "12834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2012; 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.