Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1154975118 Individual Practitioner Female Practitioner

Mackenzie Shiba , MS CCC-SLP

Speech-Language Pathologist • Lodi, CA

Professional Overview & Biography Verified Profile Summary

Mackenzie Shiba, MS CCC-SLP is a registered healthcare professional specializing in Speech-Language Pathologist in Lodi, CA. Practice services are available at 1812 W KETTLEMAN LN under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1812 W Kettleman Ln

Lodi, CA 952428224

Telephone 2092424606
Associated Practice Facility / Clinic
🏢 Bennett Medical Services Inc Facility NPI 1851661565

Specialty Benchmarks & Practice Insights

Comparative analytics for Speech-Language Pathologist in Lodi, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 14.3 Yrs
Regional Practice Density
34 Specialists

Practicing in Lodi, CA (13280 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2023-05-13
Speech-Language Pathologist Primary Specialty

NUCC Taxonomy Code: 235Z00000X

State License CA 26679

The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
Valeria Carrillo

Specialist/Technologist - Speech-Language Assistant

NPI 1427536705

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events
📍
Updated Practice Location May 13, 2023

Registered at 1812 W KETTLEMAN LN, LODI, CA 952428224 (Tel: 2092424606)

📍
Updated Business Mailing Address May 13, 2023

Registered at 16966 E FRONT ST, LINDEN, CA 952369751 (Tel: 2092424606)

👤
Provider Name / Credentials Updated May 13, 2023

Recorded as MACKENZIE SHIBA, M.S. CCC-SLP

NPI Profile Active July 29, 2019

NPI status registered as active in NPPES database

📍
Updated Practice Location July 29, 2019

Registered at 1211 S SCHOOL ST, LODI, CA 952405708 (Tel: 2092424606)

📍
Updated Business Mailing Address July 29, 2019

Registered at 1030 S HUTCHINS ST STE 4-320, LODI, CA 952405251 (Tel: 2092424606)

👤
Provider Name / Credentials Updated July 29, 2019

Recorded as MACKENZIE GOOLD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 29, 2019

Speech-Language Pathologist (License #26679 in CA)

🟢
Initial NPI Registration & Enumeration July 29, 2019

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1154975118
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 29, 2019
Last Update: May 13, 2023
Sole Proprietor: Yes

Mailing Address

16966 E Front St

Linden, CA 952369751

Phone: 2092424606

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.