Shannon Keiko Ikeda

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

9954 Issued in CA

Practice address

1720 S Amphlett Blvd
Ste 250
San Mateo, CA 94402-2702

Phone

(650) 931-6300

Fax

(650) 228-0356

NPI assigned

Apr 27, 2010

Last updated

Mar 16, 2016By the provider in NPPES

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Opya, Inc.

  • Behavior Analyst
  • San Mateo, CA
  • NPI 1992165021

  Speech-Language Pathologist

  NPD (past)

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

{
    "created_epoch": "1272326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458086400000",
    "number": "1659698876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 SCENIC DR",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940623233",
            "telephone_number": "650-931-6300",
            "fax_number": "650-228-0356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 S AMPHLETT BLVD",
            "address_2": "STE 250",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944022702",
            "telephone_number": "650-931-6300",
            "fax_number": "650-228-0356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IKEDA",
        "first_name": "SHANNON",
        "middle_name": "KEIKO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-27",
        "last_updated": "2016-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "9954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teresa Ibarra
• Glenn Gange Ibarrientos, R.N.
• Joseph Ibe, D.C.
• Ilona Ignatjeva
• Moira Ikeda, CCC-SLP
• Kathleen Ikuta, PT
• Jun Mee Im
• Shirin Shahinfar Imani, DDS
• Immediate Medical Care Inc
• Michael Stuart Immerman, MSW

• Speech-Language Pathologist in San Mateo, CA
• Providers in San Mateo, 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 16, 2016; 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.