Provider Demographics
NPI:1437307469
Name:NIKKARI, MARILYN (MS SLP CCC)
Entity Type:Individual
Prefix:MS
First Name:MARILYN
Middle Name:
Last Name:NIKKARI
Suffix:
Gender:F
Credentials:MS SLP CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1776 YGNACIO VALLEY RD
Mailing Address - Street 2:STE. 210
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-3190
Mailing Address - Country:US
Mailing Address - Phone:925-933-8462
Mailing Address - Fax:925-933-4460
Practice Address - Street 1:1776 YGNACIO VALLEY RD
Practice Address - Street 2:STE. 210
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-3190
Practice Address - Country:US
Practice Address - Phone:925-933-8462
Practice Address - Fax:925-933-4460
Is Sole Proprietor?:No
Enumeration Date:2008-09-03
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11525235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist