Individual provider Active NPI

Julie Ekkaphanh

  • Speech-Language Assistant
  • Sacramento, CA
National Provider Identifier
1629771100
Registry record updated Mar 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
6710 Issued in CA
Practice address
2115 J St Ste 210
Sacramento, CA 95816-4734
Phone
(916) 862-6110
NPI assigned
Mar 23, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X 6710 CA Primary

Addresses

Primary practice location

2115 J St Ste 210
Sacramento, CA 95816-4734

Mailing address

124 Loveland Way
Sacramento, CA 95838-2013
Phone (916) 862-6110

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

LicenseStateTypeSpecialty
6710CAMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1679529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679529600000",
    "number": "1629771100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 LOVELAND WAY",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958382013",
            "telephone_number": "916-862-6110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 J ST STE 210",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958164734",
            "telephone_number": "916-862-6110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EKKAPHANH",
        "first_name": "JULIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-23",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "CA",
            "license": "6710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2023; 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.