Organization Active NPI

Center for Speech & Language Therapy

  • Speech-Language Pathologist
  • Los Banos, CA
National Provider Identifier
1558610014
Registry record updated Aug 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
14526 Issued in CA
Legal business name
CENTER FOR SPEECH & LANGUAGE THERAPY
Practice address
312 W J St
Suite 202
Los Banos, CA 93635-4073
Phone
(209) 827-1500
Fax
(209) 827-1300
NPI assigned
Aug 30, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2012

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

Authorized official

Name
Shila Russell, M.S., CCC-SLP
Title
Owner
Phone
(209) 827-1500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X 14526 CA Primary

Addresses

Primary practice location

312 W J St
Suite 202
Los Banos, CA 93635-4073

Mailing address

312 W J St
Suite 202
Los Banos, CA 93635-4073
Phone (209) 827-1500

National Provider Directory

National Provider Directory

Locations

312 W J St
Ste 202
Los Banos, CA 93635
Phone (209) 827-1500

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1346284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346284800000",
    "number": "1558610014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 W J ST",
            "address_2": "SUITE 202",
            "city": "LOS BANOS",
            "state": "CA",
            "postal_code": "936354073",
            "telephone_number": "209-827-1500",
            "fax_number": "209-827-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 W J ST",
            "address_2": "SUITE 202",
            "city": "LOS BANOS",
            "state": "CA",
            "postal_code": "936354073",
            "telephone_number": "209-827-1500",
            "fax_number": "209-827-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR SPEECH & LANGUAGE THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-30",
        "last_updated": "2012-08-30",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "SHILA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "209-827-1500",
        "authorized_official_credential": "M.S., CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "14526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Banos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 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.