Individual provider Active NPI

Solomonraj Sunil Kumar Kathramalla, SPEECH PATHOLOGIST

  • Speech-Language Pathologist
  • Irvine, CA
National Provider Identifier
1689374175
Registry record updated Mar 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
16673 Issued in CA
Practice address
757 Beacon
Irvine, CA 92618-0857
Phone
(562) 650-5780
NPI assigned
Mar 6, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 16673 CA Primary

Addresses

Primary practice location

757 Beacon
Irvine, CA 92618-0857

Mailing address

35410 Del Rey
Dana Point, CA 92624-1814

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

LicenseStateTypeSpecialty
16673CAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1678060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678060800000",
    "number": "1689374175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35410 DEL REY",
            "city": "DANA POINT",
            "state": "CA",
            "postal_code": "926241814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "757 BEACON",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926180857",
            "telephone_number": "562-650-5780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATHRAMALLA",
        "first_name": "SOLOMONRAJ SUNIL",
        "middle_name": "KUMAR",
        "credential": "SPEECH PATHOLOGIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-06",
        "last_updated": "2023-03-06",
        "certification_date": "2023-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "16673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2023; 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.