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MACKENZIE SHIBA M.S. CCC-SLP
NPI 1154975118
Speech-Language Pathologist in Lodi, CA

Active since July 29, 2019
1812 W KETTLEMAN LN, LODI, CA 95242(209) 242-4606 Get Directions Write a Review

NPPES record last updated: May 13, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 13, 2023, Jul 29, 2019 (2 updates tracked since 2019).

About Mackenzie Shiba M.s. Ccc-slp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MACKENZIE SHIBA M.S. CCC-SLP (NPI 1154975118) is an individual speech-language pathologist provider in Lodi, California, licensed in California (26679) and active in the NPI registry since July 2019.

NPPES Registry Identity

NPI1154975118
Entity TypeIndividualFemale
Primary Taxonomy235Z00000X
Provider Legal NameMACKENZIE SHIBACredential: M.S. CCC-SLP
Location Address1812 W KETTLEMAN LNLodi, CA 95242-8224
Mailing Address16966 E Front StLinden, CA 95236-9751 · (209) 242-4606
Phone(209) 242-4606
Sole ProprietorYes
Enumeration DateJuly 29, 2019
Last NPPES UpdateMay 13, 20232 updates tracked since enumeration
NPPES CertifiedMay 13, 2023
✔ NPI 1154975118 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpeech-Language PathologistSpeech, Language and Hearing Service Providers
Taxonomy Code235Z00000X
License✔ Licensed in CA · 26679
Definition
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.
1812 W KETTLEMAN LN, Lodi, CA 95242
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Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARISA DIX M.S., CCC-SLP
Speech-Language Pathologist
1812 W KETTLEMAN LN
LODI, CA 95242
San Joaquin County (209) 683-3427
VALERIA CARRILLO
Specialist/Technologist (Speech-Language Assistant)
1812 W KETTLEMAN LN
LODI, CA 95242
San Joaquin County (209) 242-4606
BENNETT MEDICAL SERVICES INC
Durable Medical Equipment & Medical Supplies (Oxygen Equipment & Supplies)
1812 W KETTLEMAN LN, STE 3
LODI, CA 95242
San Joaquin County (209) 339-8953

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mackenzie Shiba's NPI number?

The NPI number for Mackenzie Shiba is 1154975118. It was assigned to this individual provider in the NPPES registry on July 29, 2019.

Where is Mackenzie Shiba located?

Mackenzie Shiba practices at 1812 W Kettleman Ln, Lodi, CA 95242. The listed phone number is (209) 242-4606.

What is Mackenzie Shiba's specialty?

The primary specialty registered for this NPI is Speech-Language Pathologist with taxonomy code 235Z00000X.

When was this NPI record last updated?

The NPPES record for Mackenzie Shiba was last updated on May 13, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.