Sprout Pediatric Speech Therapy Inc

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

SPROUT PEDIATRIC SPEECH THERAPY INC

Practice address

2042 Bobwhite LN
Santa Cruz, CA 95065-1853

Phone

(408) 533-2339

NPI assigned

Aug 24, 2020

Organization subpart

No

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

Authorized official

Name

Nicollette Cubbage, M.A., CCC-SLP, CMTNPI 1659983773

Title

Chief Executive Officer

Phone

(831) 471-7344

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Nicollette Anne Cubbage, MA, CCC-SLP

  • Speech-Language Pathologist
  • Santa Cruz, CA
  • NPI 1659983773
  NPD Authorized official

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

{
    "created_epoch": "1598227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716336000000",
    "number": "1679186217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9057 SOQUEL DRIVE",
            "address_2": "BUILDING A, SUITE CC",
            "city": "APTOS",
            "state": "CA",
            "postal_code": "95003",
            "telephone_number": "831-471-7344",
            "fax_number": "831-999-1131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2042 BOBWHITE LN",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950651853",
            "telephone_number": "408-533-2339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPROUT PEDIATRIC SPEECH THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-24",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-14",
        "status": "A",
        "authorized_official_last_name": "CUBBAGE",
        "authorized_official_first_name": "NICOLLETTE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "831-471-7344",
        "authorized_official_credential": "M.A., CCC-SLP, CMT"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Holly M. Z. Spiers, M.A., LMFT
• Daniel A Spilman, MD
• Lawrence J. Spingola, M.D.
• James Spitler, M.D.
• Anna Spix, PT
• Louisa Squires, MFT
• Tina Srbulovic
• Jennifer Lynn Sredniawa, LCSW
• Padmashri Komandur Srinivasa, MD
• Nithya Sritharan, M.D

• Speech-Language Pathologist in Santa Cruz, CA
• Providers in Santa Cruz, 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 22, 2024; 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.