Patricia Anne Tanael Medalla, M.S. CCC-SLP
NPI 1255969176ActiveIndividual· Speech-Language Pathologist· Fremont, CA
Speech-Language Pathologist (M.S. CCC-SLP) in Fremont, California, licensed in CA, with an NPI issued in March 2020. Enrolled in Medicare as practitioner - qualified speech language pathologist.
Overview
| NPI | 1255969176 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | M.S. CCC-SLP |
| Sole proprietor | Yes |
| NPI issued | Mar 27, 2020 |
| Last updated in NPPES | Feb 11, 2022 |
| Certified by provider | Aug 31, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Speech-Language Pathologist Primary | 235Z00000X | 28937 | CA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Qualified Speech Language Pathologist (CA) |
|---|
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