Active NPI
Annette Waters
- Speech-Language Pathologist
- San Carlos, CA
National Provider Identifier
1629527825
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 18014
- Practice address
- 1017 Cedar St
San Carlos, CA 94070 - Phone
- (650) 244-1519
- NPI assigned
- Sep 28, 2016
- Sex
- Female
- Sole proprietor
- Yes
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 | 18014 | CA | Primary |
Addresses
Primary practice location
1017 Cedar St
San Carlos, CA 94070
Mailing address
373 Brookmere Dr.
San Jose, CA 95123
Phone (916) 230-2104
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Qualified Speech Language Pathologist
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
Palm Desert, CA 92260
Phone (877) 407-3422
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
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 and National Provider Directory roles.
-
- Physical Therapist
- San Diego, CA
- NPI 1972330298
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1475020800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1557964800000",
"number": "1629527825",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "373 BROOKMERE DR.",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "95123",
"telephone_number": "916-230-2104"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1017 CEDAR ST",
"city": "SAN CARLOS",
"state": "CA",
"postal_code": "94070",
"telephone_number": "650-244-1519"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATERS",
"first_name": "ANNETTE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-09-28",
"last_updated": "2019-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "18014",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Carlos, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.