Active NPI
Mariyah Velarde-Greene, SLPA
- Speech-Language Assistant
- Fairfield, CA
National Provider Identifier
1679121503
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Assistant
- License
- 4440
- Practice address
- 1261 Travis Blvd Ste 120
Fairfield, CA 94533-4804 - Phone
- (707) 344-1777
- NPI assigned
- Sep 4, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Assistant | 2355S0801X | 4440 | CA | Primary |
Addresses
Primary practice location
1261 Travis Blvd Ste 120
Fairfield, CA 94533-4804
Mailing address
100 Bicentennial Cir Apt 112
Sacramento, CA 95826-2852
Phone (916) 893-3324
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4440 | CA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1567555200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1567555200000",
"number": "1679121503",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 BICENTENNIAL CIR APT 112",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958262852",
"telephone_number": "916-893-3324"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1261 TRAVIS BLVD STE 120",
"city": "FAIRFIELD",
"state": "CA",
"postal_code": "945334804",
"telephone_number": "707-344-1777"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VELARDE-GREENE",
"first_name": "MARIYAH",
"credential": "SLPA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-04",
"last_updated": "2019-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "2355S0801X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Speech-Language Assistant",
"state": "CA",
"license": "4440",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfield, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.