Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1831021971 Individual Practitioner Female Practitioner

Amy Thistle Tackett , CCC-SLP

Speech-Language Pathologist • Marina, CA

Professional Overview & Biography Verified Profile Summary

Amy Tackett, CCC-SLP is a registered healthcare professional specializing in Speech-Language Pathologist in Marina, CA. Practice services are available at 298 PATTON PKWY under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

298 Patton Pkwy

Marina, CA 939336007

Telephone 8312201763

Specialty Benchmarks & Practice Insights

Comparative analytics for Speech-Language Pathologist in Marina, CA

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

Practicing in Marina, 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: 2026-06-02
Speech-Language Pathologist Primary Specialty

NUCC Taxonomy Code: 235Z00000X

State License CA 21919

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

3 Associated Practitioners
Araceli Canchola , PPS

Counselor - School

NPI 1841134004
Angela Olson , PPS

Counselor - School

NPI 1942144100
Jeffrey Lehner

Social Worker - Clinical

NPI 1982413720

Career & Practice History Timeline

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

6 Historical Events
NPI Profile Active June 02, 2026

NPI status registered as active in NPPES database

📍
Updated Practice Location June 02, 2026

Registered at 298 PATTON PKWY, MARINA, CA 939336007 (Tel: 8312201763)

📍
Updated Business Mailing Address June 02, 2026

Registered at 231 MCCULLOCH CIR, MARINA, CA 939332404 (Tel: 8312201763)

👤
Provider Name / Credentials Updated June 02, 2026

Recorded as AMY TACKETT, CCC-SLP

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 02, 2026

Speech-Language Pathologist (License #21919 in CA)

🟢
Initial NPI Registration & Enumeration June 02, 2026

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: 1831021971
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 02, 2026
Last Update: June 02, 2026
Sole Proprietor: No

Mailing Address

231 Mcculloch Cir

Marina, CA 939332404

Phone: 8312201763

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.