Individual provider Active NPI

Randal Glynn, CCC-SLP

  • Speech-Language Pathologist
  • Dublin, CA
National Provider Identifier
1699136903
Registry record updated Mar 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
23226 Issued in CA
Practice address
9801 Dublin Blvd
Dublin, CA 94568-2835
Phone
(877) 543-7852
NPI assigned
Mar 14, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2016

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 23226 CA Primary

Addresses

Primary practice location

9801 Dublin Blvd
Dublin, CA 94568-2835

Mailing address

314 Perkins St Apt 210
Oakland, CA 94610-3420
Phone (908) 892-3086

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

NPI Registry JSON

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

{
    "created_epoch": "1457913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457913600000",
    "number": "1699136903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 PERKINS ST APT 210",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946103420",
            "telephone_number": "908-892-3086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9801 DUBLIN BLVD",
            "city": "DUBLIN",
            "state": "CA",
            "postal_code": "945682835",
            "telephone_number": "877-543-7852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLYNN",
        "first_name": "RANDAL",
        "name_prefix": "Ms.",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-14",
        "last_updated": "2016-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "23226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dublin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 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.