Active NPI
Stefanie Shanley, CCC-SLP
- Speech-Language Pathologist
- Walnut Creek, CA
National Provider Identifier
1699233791
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SP11138
- Practice address
- 22 Acorn CT
Walnut Creek, CA 94595-1444 - Phone
- (925) 988-0741
- NPI assigned
- Mar 7, 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 Pathologist | 235Z00000X | SP11138 | CA | Primary |
Addresses
Primary practice location
22 Acorn CT
Walnut Creek, CA 94595-1444
Mailing address
22 Acorn CT
Walnut Creek, CA 94595-1444
Phone (925) 988-0741
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 |
|---|---|---|---|
| SP11138 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1551916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606694400000",
"number": "1699233791",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22 ACORN CT",
"city": "WALNUT CREEK",
"state": "CA",
"postal_code": "945951444",
"telephone_number": "925-988-0741"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22 ACORN CT",
"city": "WALNUT CREEK",
"state": "CA",
"postal_code": "945951444",
"telephone_number": "925-988-0741"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHANLEY",
"first_name": "STEFANIE",
"credential": "CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-03-07",
"last_updated": "2020-11-30",
"certification_date": "2020-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "SP11138",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Walnut Creek, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.