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NPI 1962393330ActiveIndividual· Speech-Language Pathologist· Antioch, CA
Speech-Language Pathologist in Antioch, California, with an NPI issued in July 2025. Enrolled in Medicare as practitioner - qualified speech language pathologist.
Overview
| NPI | 1962393330 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | No |
| NPI issued | Jul 14, 2025 |
| Last updated in NPPES | Jul 14, 2025 |
| Certified by provider | Jul 13, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Speech-Language Pathologist Primary | 235Z00000X | — | — |
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) |
|---|
Education and affiliations
| Graduation year | 2024 |
|---|---|
| Medicare specialty | Qualified Speech Language Pathologist |
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All 19 speech-language pathologists in Antioch · All speech-language pathologists in California