Theresa Patrice Lopez Ravago

Primary specialty

AudiologistTaxonomy code 231H00000X

Practice address

2923 Webster St Ste 201
Oakland, CA 94609-3418

Phone

(510) 752-8330

NPI assigned

Jul 8, 2021

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Theresa Patrice Ravago Mireles Other name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Kaiser Permanente

  • Hearing and Speech Clinic/Center
  • Oakland, CA
  • NPI 1437438140
  NPD (past)

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

{
    "created_epoch": "1625702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641859200000",
    "number": "1992376123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2505 HAZELWOOD AVE",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952071309",
            "telephone_number": "209-337-8227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2923 WEBSTER ST STE 201",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093418",
            "telephone_number": "510-752-8330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAVAGO",
        "first_name": "THERESA PATRICE",
        "middle_name": "LOPEZ",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-08",
        "last_updated": "2022-01-11",
        "certification_date": "2021-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "710 S Broadway",
            "city": "Walnut Creek",
            "state": "CA",
            "country_code": "US",
            "postal_code": "945965294",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "THERESA PATRICE",
            "last_name": "MIRELES",
            "middle_name": "RAVAGO",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Laura Rombach Rau
• Loren C. Rauch, MD
• Melissa W Rauch, CPM
• Jeanette Melissa Rauda-Leon
• Spencer William Rava
• Kavian Massoud Ravandoust, LMFT
• Jayalakshmi Ravindran, M.D.
• Anthony S. Ravnik, M.D.
• Andrew T. Rawles, PT
• Danielle Elizabeth Ray, LMFT

• Audiologist in Oakland, CA
• Providers in Oakland, CA by specialty
• Audiologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2022; 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.