Individual provider Active NPI

Martha J Rivas-Mendoza

  • Speech-Language Assistant
  • Sherman Oaks, CA
National Provider Identifier
1821504911
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
874 Issued in CA
Practice address
3130 Burbank Blvd
Sherman Oaks, CA 91401
Phone
(818) 781-0360
NPI assigned
Dec 27, 2017
Last updated
Jun 16, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 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 Assistant 2355S0801X 874 CA Primary

Addresses

Primary practice location

3130 Burbank Blvd
Sherman Oaks, CA 91401

Mailing address

6071 La Prada St Apt 8
Los Angeles, CA 90042-2063
Phone (818) 781-0360

Other practice location 1

16500 Ventura Blvd Ste 414
Encino, CA 91436-5050
Phone (818) 788-1003

Other identifiers 1

IdentifierTypeStateIssuer
874OtherCASPEECH PATHOLOGY AND AUDIOLOGY AND HEARING AID DISPENSERS BOARD

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

NPI Registry JSON

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

{
    "created_epoch": "1514332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1821504911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6071 LA PRADA ST APT 8",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900422063",
            "telephone_number": "818-781-0360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3130 BURBANK BLVD",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "91401",
            "telephone_number": "818-781-0360"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16500 Ventura Blvd Ste 414",
            "address_purpose": "LOCATION",
            "city": "Encino",
            "state": "CA",
            "postal_code": "914365050",
            "country_code": "US",
            "telephone_number": "818-788-1003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIVAS-MENDOZA",
        "first_name": "MARTHA",
        "middle_name": "J",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-27",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "CA",
            "license": "874",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPEECH PATHOLOGY AND AUDIOLOGY AND HEARING AID DISPENSERS BOARD",
            "identifier": "874",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherman Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.