Healthcare Provider Details

I. General information

NPI: 1174438436
Provider Name (Legal Business Name): SIERRA NICOLE STONE CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5301 F ST
SACRAMENTO CA
95819-3226
US

IV. Provider business mailing address

806 25TH ST APT B
SACRAMENTO CA
95816-4264
US

V. Phone/Fax

Practice location:
  • Phone: 916-999-5395
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number38849
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: