Individual provider Active NPI

Charlotte Marie Lopes Rubin, M.A.

  • Speech-Language Pathologist
  • San Diego, CA
National Provider Identifier
1972709640
Registry record updated Dec 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP6329 Issued in CA
Practice address
3250 Wing St
San Diego, CA 92110-4624
Phone
(619) 221-6000
NPI assigned
Jun 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2021

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 SP6329 CA Primary

Addresses

Primary practice location

3250 Wing St
San Diego, CA 92110-4624

Mailing address

6344 Coral Lake Ave
San Diego, CA 92119-2507
Phone (619) 825-6144

Other names 1

  • Charlotte Marie Lopes Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
SP6329CAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1182384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639526400000",
    "number": "1972709640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6344 CORAL LAKE AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921192507",
            "telephone_number": "619-825-6144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3250 WING ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921104624",
            "telephone_number": "619-221-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPES RUBIN",
        "first_name": "CHARLOTTE",
        "middle_name": "MARIE",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-21",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "SP6329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4647 Zion Ave",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921202507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CHARLOTTE",
            "last_name": "LOPES",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 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.

Verify at the official NPI Registry.