Individual provider Active NPI

Kristen Jennifer Rohde, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Ventura, CA
National Provider Identifier
1720209323
Registry record updated Jan 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP16012 Issued in CA
Practice address
4562 Westinghouse St Ste a
Ventura, CA 93003-5797
Phone
(805) 644-8255
NPI assigned
May 1, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2018

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 SP16012 CA Primary

Addresses

Primary practice location

4562 Westinghouse St Ste a
Ventura, CA 93003-5797

Mailing address

1562 Lobelia Avenue
Ventura, CA 93004
Phone (805) 647-0177

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
SP16012CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Seaside Speech Therapy, Inc. Speech-Language Pathologist Past Accepting new patients
Seaside Speech Therapy, Inc Speech-Language Pathologist Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517356800000",
    "number": "1720209323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1562 LOBELIA AVENUE",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "93004",
            "telephone_number": "805-647-0177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4562 WESTINGHOUSE ST STE A",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930035797",
            "telephone_number": "805-644-8255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROHDE",
        "first_name": "KRISTEN",
        "middle_name": "JENNIFER",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2018-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "SP16012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ventura, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2018; 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.