Sharon Kay Gray, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

29484 Issued in CA

Practice address

485 N Michillinda Ave
Pasadena, CA 91107-2262

Phone

(315) 402-5529

NPI assigned

Mar 7, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Sharon Kay Nickelson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1615075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615075200000",
    "number": "1639764012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "485 N MICHILLINDA AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911072262",
            "telephone_number": "315-402-5529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "485 N MICHILLINDA AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911072262",
            "telephone_number": "315-402-5529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "SHARON",
        "middle_name": "KAY",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-07",
        "last_updated": "2021-03-07",
        "certification_date": "2021-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "29484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHARON",
            "last_name": "NICKELSON",
            "middle_name": "KAY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Megan Elizabeth Gravenstein
• James Stephen Graves, PHD, PSYD
• Marcus Graves
• Catherine Lynn Gray, PSY.D.
• Megan A Gray, PSY.D.
• Rachel Grayczyk
• Jonathan Bruce Grayson, PH.D.
• Great Company (986 Pharmacy #8032)
• Nicholas Withrow Greco, M.D.
• Roberta Diane Green PH.D., MSW, PH.D.

• Speech-Language Pathologist in Pasadena, CA
• Providers in Pasadena, CA by specialty
• Speech-Language Pathologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2021; 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.