Putta Divya Mutharaju, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

31155 Issued in CA

Practice address

5870 El Camino Real Ste 101
Carlsbad, CA 92008-8816

Phone

(760) 539-5818

NPI assigned

May 21, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14973/brand/8/csg/1/fhir/r4

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.

• Cortica Healthcare Inc

  • Health Service Clinic/Center
  • San Diego, CA
  • NPI 1801288535
  NPD (past)
• Cortica Developmental Therapies PA

  • Multi-Specialty Clinic/Center
  • Plano, TX
  • NPI 1619554680
  NPD (past)

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

{
    "created_epoch": "1621555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621555200000",
    "number": "1649845736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10278 BLACK MOUNTAIN RD APT 171",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921263833",
            "telephone_number": "408-601-8493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5870 EL CAMINO REAL STE 101",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920088816",
            "telephone_number": "760-539-5818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUTHARAJU",
        "first_name": "PUTTA DIVYA",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-21",
        "last_updated": "2021-05-21",
        "certification_date": "2021-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "31155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dianne Marie Murray Moore, OTR/L
• Alexandra Murray, RN, IBCLC
• Kristen Musacco, OTD, OTR/L
• Mari Muscio
• Oksana Mushchenko
• Muv Physical Therapy, Inc.
• Stephanie Myung
• Maysa K Nagi, MD
• Simrandeep Kaur Nagra
• Martina Nagy, M.T.

• Speech-Language Pathologist in Carlsbad, CA
• Providers in Carlsbad, 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 May 21, 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.