Mia Theis

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

16719 Issued in CA

Practice address

10305 Promenade Pkwy
Elk Grove, CA 95757-9400

Phone

(916) 688-2000

NPI assigned

Aug 3, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mia Rodriquez Former name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299
  Medicare reassignment NPD
• Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
  • NPI 1497971584
  NPD
• Total Education Solutions

  • Early Intervention Provider Agency
  • Rancho Cordova, CA
  • NPI 1841586757

  Speech-Language Pathologist

  NPD
• Total Education Solutions Inc

  • Medical Specialty Clinic/Center
  • Los Angeles, CA
  • NPI 1659535052

  Speech-Language Pathologist

  NPD (past)

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

{
    "created_epoch": "1659484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750291200000",
    "number": "1699402297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3320 DATA DR STE 400",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956707341",
            "telephone_number": "916-564-5010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10305 PROMENADE PKWY",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957579400",
            "telephone_number": "916-688-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEIS",
        "first_name": "MIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-03",
        "last_updated": "2025-06-19",
        "certification_date": "2025-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "16719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIA",
            "last_name": "RODRIQUEZ",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• The Growth Center I Inc.
• The Growth Center I Inc.
• The Growth Center I Inc.
• The Lotus Center Incorporated
• The Self-Care Academy, Inc.
• Annette C Theisen, RPH
• Chelsie June-Marie Theodore
• Julie A Theriault, PA
• Sequoia Therman
• Third Optometric Care of California

• Speech-Language Pathologist in Elk Grove, CA
• Providers in Elk Grove, 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 Jun 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.