Organization Active NPI

Susan E Whitaker Shasta Speech & Language

  • Speech-Language Pathologist
  • Redding, CA
National Provider Identifier
1568782985
Registry record updated Mar 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP3559 Issued in CA
Legal business name
SUSAN E WHITAKER SHASTA SPEECH & LANGUAGE
Practice address
2208 Park Marina Dr
Redding, CA 96001-2111
Phone
(530) 244-0263
Fax
(530) 247-0688
NPI assigned
Jun 8, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2012

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

Authorized official

Name
Susan E Whitaker, S.P.NPI 1336113737
Title
Owner
Phone
(530) 244-0263

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X SP3559 CA Primary

Addresses

Primary practice location

2208 Park Marina Dr
Redding, CA 96001-2111

Mailing address

PO Box 496084
Redding, CA 96049-6084
Phone (530) 244-0263

Other identifiers 1

IdentifierTypeStateIssuer
2009-0001238OtherCAFICTITITIOUS BUSINESS NAME

National Provider Directory

National Provider Directory

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": "1275955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333065600000",
    "number": "1568782985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 496084",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960496084",
            "telephone_number": "530-244-0263",
            "fax_number": "530-247-0688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2208 PARK MARINA DR",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960012111",
            "telephone_number": "530-244-0263",
            "fax_number": "530-247-0688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSAN E WHITAKER SHASTA SPEECH & LANGUAGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-08",
        "last_updated": "2012-03-30",
        "status": "A",
        "authorized_official_last_name": "WHITAKER",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "530-244-0263",
        "authorized_official_credential": "S.P."
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "SP3559",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FICTITITIOUS BUSINESS NAME",
            "identifier": "2009-0001238",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

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