Individual provider Active NPI

Jamie Mariscal

  • Speech-Language Pathologist
  • Santa Rosa, CA
National Provider Identifier
1730091158
Registry record updated Sep 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
21482 Issued in CA
Practice address
110 Stony Point Rd Ste 210
Santa Rosa, CA 95401-4118
Phone
(707) 890-3800
NPI assigned
Sep 21, 2026
Last updated
Sep 21, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2026

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 21482 CA Primary

Addresses

Primary practice location

110 Stony Point Rd Ste 210
Santa Rosa, CA 95401-4118

Mailing address

110 Stony Point Rd Ste 210
Santa Rosa, CA 95401-4118
Phone (707) 890-3800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1789948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789948800000",
    "number": "1730091158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 STONY POINT RD STE 210",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954014118",
            "telephone_number": "707-890-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 STONY POINT RD STE 210",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954014118",
            "telephone_number": "707-890-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARISCAL",
        "first_name": "JAMIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-21",
        "last_updated": "2026-09-21",
        "certification_date": "2026-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "21482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.