Colleen Cleary, MS, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

24429 Issued in CA

Practice address

2021 Ygnacio Valley Rd
Walnut Creek, CA 94598-3391

Phone

(925) 822-7776

Fax

(925) 822-7776

NPI assigned

Mar 15, 2018

Sex

Female

Sole proprietor

No

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.

• The Speech Pathology Group, Inc

  • Early Intervention Provider Agency
  • Walnut Creek, CA
  • NPI 1225378532
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 15, 2018.

{
    "created_epoch": "1521072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521072000000",
    "number": "1689177693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2021 YGNACIO VALLEY RD STE C202",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945983392",
            "telephone_number": "925-945-1474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 YGNACIO VALLEY RD",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945983391",
            "telephone_number": "925-822-7776",
            "fax_number": "925-822-7776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEARY",
        "first_name": "COLLEEN",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-15",
        "last_updated": "2018-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "24429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristin Ann Clark
• Mary Angelyn Joves Clark, MSN, APRN
• Naomi Clark
• Samantha Clark
• Tyler Randolph Clark, MD
• Mikaela Cleland, BS
• Mary V. Clemency, MD
• Samantha Cristina Clemens, PH.D.
• David Clemons, MD
• Thomas L Clennell, D.P.T.

• All providers in Walnut Creek, CA
• Speech-Language Pathologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2018; 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.