Organization Name: | JOSELYNNE JAQUES |
NPI Number: | 1447560362 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ROBERT JAQUES (BUSINESS MANAGER) |
Mailing Address: | 10 Fortuna W Irvine |
State: | CA US |
Postal Code: | 926201848 |
Phone Number: | 7142353053 |
Fax Number: | 7143843899 |
NPI Enumeration Date: | 10/13/2010 |
NPI Last Update Date: | 10/13/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 13783 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |