1336885060 NPI number — STEPHANIE MARIE BARKL M.S.,CCC-SLP

NPI Number: 1336885060
Health Care Provider/Practitioner: STEPHANIE MARIE BARKL M.S.,CCC-SLP

NPI Number : 1336885060 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1336885060",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BARKL",
    "FirstName": "STEPHANIE",
    "MiddleName": "MARIE",
    "NamePrefix": "MS.",
    "NameSuffix": null,
    "Credential": "M.S.,CCC-SLP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "GOLDFIN",
    "OtherFirstName": "STEPHANIE",
    "OtherMiddleName": "MARIE",
    "OtherNamePrefix": "MISS",
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "7514 STUEBEN WAY",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "STOCKTON",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "95207-1233",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "775-250-3506",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "7514 STUEBEN WAY",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "STOCKTON",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "95207-1233",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "775-250-3506",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "05/06/2022",
    "LastUpdateDate": "05/06/2022",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "235Z00000X",
          "TaxonomyName": "Speech-Language Pathologist",
          "LicenseNumber": "SP2679",
          "LicenseNumberStateCode": "NV",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "235Z00000X",
          "TaxonomyName": "Speech-Language Pathologist",
          "LicenseNumber": "016708",
          "LicenseNumberStateCode": "OR",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "235Z00000X",
          "TaxonomyName": "Speech-Language Pathologist",
          "LicenseNumber": "29922",
          "LicenseNumberStateCode": "CA",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}