Individual provider Active NPI

Jennifer Nevolo Alwood

  • Speech-Language Pathologist
  • Santa Rosa, CA
National Provider Identifier
1982352605
Registry record updated Jul 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
17308 Issued in CA
Practice address
1144 Sonoma Ave Ste 121
Santa Rosa, CA 95405-4812
Phone
(707) 542-1010
NPI assigned
Mar 11, 2022
Last updated
Jul 26, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 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 17308 CA Primary

Addresses

Primary practice location

1144 Sonoma Ave Ste 121
Santa Rosa, CA 95405-4812

Mailing address

708 Gravenstein Hwy N # 245
Sebastopol, CA 95472-2808
Phone (707) 547-7630

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
17308CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Santa Rosa Speech Therapy, PC Speech-Language Pathologist CurrentSince Jun 21, 2022 Accepting new patients
Santa Rosa Speech & Language Services Speech-Language Pathologist PastSince Mar 1, 2022 Accepting new patients

Locations

1212 College Ave
Ste A
Santa Rosa, CA 95404
Phone (707) 210-5350

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1646956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690329600000",
    "number": "1982352605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "708 GRAVENSTEIN HWY N # 245",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954722808",
            "telephone_number": "707-547-7630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1144 SONOMA AVE STE 121",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054812",
            "telephone_number": "707-542-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALWOOD",
        "first_name": "JENNIFER",
        "middle_name": "NEVOLO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-11",
        "last_updated": "2023-07-26",
        "certification_date": "2023-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "17308",
            "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 Jul 26, 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.