Active NPI
Nina Kae Fucile, S.L.P.
- Speech-Language Pathologist
- Roseville, CA
National Provider Identifier
1710169131
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 9964
- Practice address
- 2530 Douglas Blvd
Roseville, CA 95661-3989 - Phone
- (916) 797-3307
- NPI assigned
- Nov 27, 2007
- 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 | 9964 | CA | Primary |
Addresses
Primary practice location
2530 Douglas Blvd
Roseville, CA 95661-3989
Mailing address
4920 Hartwick CT
Rocklin, CA 95765-5253
Phone (916) 626-1915
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 |
|---|---|---|---|
| 9964 | CA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1196121600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1413504000000",
"number": "1710169131",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4920 HARTWICK CT",
"city": "ROCKLIN",
"state": "CA",
"postal_code": "957655253",
"telephone_number": "916-626-1915"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2530 DOUGLAS BLVD",
"city": "ROSEVILLE",
"state": "CA",
"postal_code": "956613989",
"telephone_number": "916-797-3307"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FUCILE",
"first_name": "NINA",
"middle_name": "KAE",
"credential": "S.L.P.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-11-27",
"last_updated": "2014-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "9964",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roseville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.