Provider Demographics
NPI:1841742541
Name:NAMBOODIRIPAD, SHEELA
Entity Type:Individual
Prefix:
First Name:SHEELA
Middle Name:
Last Name:NAMBOODIRIPAD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16545 DE WITT AVE
Mailing Address - Street 2:
Mailing Address - City:MORGAN HILL
Mailing Address - State:CA
Mailing Address - Zip Code:95037-4711
Mailing Address - Country:US
Mailing Address - Phone:669-258-9134
Mailing Address - Fax:
Practice Address - Street 1:16545 DE WITT AVE
Practice Address - Street 2:
Practice Address - City:MORGAN HILL
Practice Address - State:CA
Practice Address - Zip Code:95037-4711
Practice Address - Country:US
Practice Address - Phone:669-258-9134
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-28
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15157235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist