Active NPI
Gnoodle
- Speech-Language Pathologist
- Santa Rosa, CA
National Provider Identifier
1962160655
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- Legal business name
- GNOODLE
- Practice address
- 5460 Skylane Blvd Ste C
Santa Rosa, CA 95403-1793 - Phone
- (775) 354-9706
- NPI assigned
- Nov 30, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Thomas Bishop, MS
- Title
- Executive Director
- Phone
- (775) 354-9706
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | Primary |
Addresses
Primary practice location
5460 Skylane Blvd Ste C
Santa Rosa, CA 95403-1793
Mailing address
422 Larkfield Ctr # 310
Santa Rosa, CA 95403-1408
Phone (775) 354-9706
National Provider Directory
National Provider DirectoryLocations
5460 Skylane Blvd
Ste C
Santa Rosa, CA 95403
Phone (707) 755-5060
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Speech-Language Pathologist
- Santa Rosa, CA
- NPI 1811200298
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1638230400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1638230400000",
"number": "1962160655",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "422 LARKFIELD CTR # 310",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954031408",
"telephone_number": "775-354-9706"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5460 SKYLANE BLVD STE C",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954031793",
"telephone_number": "775-354-9706"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GNOODLE",
"organizational_subpart": "NO",
"enumeration_date": "2021-11-30",
"last_updated": "2021-11-30",
"certification_date": "2021-11-30",
"status": "A",
"authorized_official_last_name": "BISHOP",
"authorized_official_first_name": "THOMAS",
"authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
"authorized_official_telephone_number": "775-354-9706",
"authorized_official_credential": "MS"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Speech-Language Pathologist",
"state": null,
"license": null,
"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 Nov 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.