Miellie Bazzano

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

41468 Issued in CA

Practice address

3925 Old Redwood Hwy Ofc 4
Santa Rosa, CA 95403-1719

Phone

(707) 393-4033

NPI assigned

Apr 8, 2026

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

Other names 1

• Miellie Bazzano-Cook Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1775606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784505600000",
    "number": "1659213544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18262 N SHORE DR",
            "city": "HIDDEN VALLEY LAKE",
            "state": "CA",
            "postal_code": "954678624",
            "telephone_number": "707-900-8994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3925 OLD REDWOOD HWY OFC 4",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954031719",
            "telephone_number": "707-393-4033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAZZANO",
        "first_name": "MIELLIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-08",
        "last_updated": "2026-07-20",
        "certification_date": "2026-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "41468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIELLIE",
            "last_name": "BAZZANO-COOK",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Speech-Language Pathologist in Santa Rosa, CA
• Providers in Santa Rosa, 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 Jul 20, 2026; 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.