Active NPI
Ketaki Vaidya
- Speech-Language Pathologist
- Castro Valley, CA
National Provider Identifier
1609130442
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 19757
- Practice address
- 21966 Dolores St
Castro Valley, CA 94546-6900 - Phone
- (510) 733-2102
- NPI assigned
- Jun 26, 2012
- 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 | 19757 | CA | Primary |
Addresses
Primary practice location
21966 Dolores St
Castro Valley, CA 94546-6900
Mailing address
1401 Red Hawk Cir Apt I202
Fremont, CA 94538-4765
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 |
|---|---|---|---|
| 19757 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1340668800000",
"number": "1609130442",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1401 RED HAWK CIR APT I202",
"city": "FREMONT",
"state": "CA",
"postal_code": "945384765"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21966 DOLORES ST",
"city": "CASTRO VALLEY",
"state": "CA",
"postal_code": "945466900",
"telephone_number": "510-733-2102"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAIDYA",
"first_name": "KETAKI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-06-26",
"last_updated": "2012-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "19757",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Castro Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 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.