Individual provider Active NPI

Amanda Margaret Roebuck

  • Speech-Language Assistant
  • Riverside, CA
National Provider Identifier
1922491281
Registry record updated Mar 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
2424 Issued in CA
Practice address
3669 Briscoe St
Riverside, CA 92506-1894
Phone
(951) 662-3478
NPI assigned
Mar 11, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2015

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 2424 CA Primary

Addresses

Primary practice location

3669 Briscoe St
Riverside, CA 92506-1894

Mailing address

3669 Briscoe St
Riverside, CA 92506-1894
Phone (951) 662-3478

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
2424CAMDSpeech-Language Assistant

NPI Registry JSON

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

{
    "created_epoch": "1426032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426032000000",
    "number": "1922491281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3669 BRISCOE ST",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925061894",
            "telephone_number": "951-662-3478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3669 BRISCOE ST",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925061894",
            "telephone_number": "951-662-3478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROEBUCK",
        "first_name": "AMANDA",
        "middle_name": "MARGARET",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-11",
        "last_updated": "2015-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "CA",
            "license": "2424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2015; 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.