Active NPI
Shannon Helen Sutherland, SLP
- Speech-Language Pathologist
- Thousand Oaks, CA
National Provider Identifier
1609025675
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SP 9928
- Practice address
- 509 Marin St
Thousand Oaks, CA 91360-4261 - Phone
- (805) 230-2323
- Fax
- (805) 230-2322
- NPI assigned
- Sep 15, 2008
- Last updated
- Sep 15, 2008
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SP 9928 | CA | Primary |
Addresses
Primary practice location
509 Marin St
Thousand Oaks, CA 91360-4261
Mailing address
509 Marin St
Thousand Oaks, CA 91360-4261
Phone (805) 230-2323
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 |
|---|---|---|---|
| SP 9928 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221436800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1221436800000",
"number": "1609025675",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "509 MARIN ST",
"city": "THOUSAND OAKS",
"state": "CA",
"postal_code": "913604261",
"telephone_number": "805-230-2323",
"fax_number": "805-230-2322"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "509 MARIN ST",
"city": "THOUSAND OAKS",
"state": "CA",
"postal_code": "913604261",
"telephone_number": "805-230-2323",
"fax_number": "805-230-2322"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUTHERLAND",
"first_name": "SHANNON",
"middle_name": "HELEN",
"credential": "SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-09-15",
"last_updated": "2008-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "SP 9928",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Thousand Oaks, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.