Ericca Nicole Cook, CCC-SLPT

Individual provider Active NPI Speech-Language Pathologist · Redlands, CA

NPI 1982104311 · NPPES record last updated Feb 12, 2018

Key facts

NPI
1982104311
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
26287 (CA)
Practice address
112 11TH St
Redlands, CA 92374-3566
Phone
(909) 792-0543
NPI assigned
Feb 12, 2018
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
26287CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Playworks Center for Development and Learning, Inc. Speech-Language Pathologist Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 26287 CA Yes

Addresses

Primary practice location

112 11TH St
Redlands, CA 92374-3566

Mailing address

112 11TH St
Redlands, CA 92374-3566
Phone (909) 792-0543

Other providers in Redlands, CA

All providers in Redlands, CA · Speech-Language Pathologist in California

Sources for this page

Verify at the official NPI Registry.