Individual provider Active NPI

Corrie Beth Raphael, CCC-SLP

  • Speech-Language Pathologist
  • San Ramon, CA
National Provider Identifier
1639422850
Registry record updated Oct 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
15951 Issued in CA
Practice address
2208 Camino Ramon
Suite B
San Ramon, CA 94583-1328
Phone
(925) 830-5513
NPI assigned
Oct 25, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 15951 CA Primary

Addresses

Primary practice location

2208 Camino Ramon
Suite B
San Ramon, CA 94583-1328

Mailing address

39 El Gavilan Rd
Orinda, CA 94563-1907
Phone (925) 528-9976

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
15951CAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1351123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351123200000",
    "number": "1639422850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 EL GAVILAN RD",
            "city": "ORINDA",
            "state": "CA",
            "postal_code": "945631907",
            "telephone_number": "925-528-9976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2208 CAMINO RAMON",
            "address_2": "SUITE B",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945831328",
            "telephone_number": "925-830-5513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAPHAEL",
        "first_name": "CORRIE",
        "middle_name": "BETH",
        "name_prefix": "Mrs.",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-25",
        "last_updated": "2012-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "15951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Ramon, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 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.