Individual provider Active NPI

Rachel Marie Ivaldi, CCC-SLP

  • Speech-Language Pathologist
  • Santa Rosa, CA
National Provider Identifier
1821872573
Registry record updated Aug 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
17929 Issued in CA
Practice address
1144 Sonoma Ave
Santa Rosa, CA 95405-4812
Phone
(707) 542-1010
NPI assigned
Aug 23, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2023

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 17929 CA Primary

Addresses

Primary practice location

1144 Sonoma Ave
Santa Rosa, CA 95405-4812

Mailing address

1655 Centurion Dr
Santa Rosa, CA 95403-4153
Phone (707) 478-3992

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
17929CAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1692748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692748800000",
    "number": "1821872573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1655 CENTURION DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954034153",
            "telephone_number": "707-478-3992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1144 SONOMA AVE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054812",
            "telephone_number": "707-542-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVALDI",
        "first_name": "RACHEL",
        "middle_name": "MARIE",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-23",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "17929",
            "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 Aug 23, 2023; 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.