Individual provider Active NPI

Sarah Elizabeth Vandenburg

  • Speech-Language Assistant
  • Lodi, CA
National Provider Identifier
1811862345
Registry record updated Oct 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
6697 Issued in CA
Practice address
1812 W Kettleman LN Ste 1
Lodi, CA 95242-4209
Phone
(209) 747-2873
Fax
(209) 747-2873
NPI assigned
Oct 6, 2025
Last updated
Oct 6, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X 6697 CA Primary

Addresses

Primary practice location

1812 W Kettleman LN Ste 1
Lodi, CA 95242-4209

Mailing address

400 S Orange Ave
Lodi, CA 95240-3804

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

LicenseStateTypeSpecialty
6697CAMDSpeech-Language Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Communication Blooms Speech Therapy Inc. CurrentSince Oct 12, 2025 Accepting new patients

Locations

1812 W Kettleman Ln
Ste 1
Lodi, CA 95242
Phone (209) 242-4606

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1759708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759708800000",
    "number": "1811862345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 S ORANGE AVE",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952403804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1812 W KETTLEMAN LN STE 1",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952424209",
            "telephone_number": "209-747-2873",
            "fax_number": "209-747-2873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDENBURG",
        "first_name": "SARAH",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-06",
        "last_updated": "2025-10-06",
        "certification_date": "2025-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "CA",
            "license": "6697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lodi, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2025; 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.