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NPI Code Detail

MEDICARE: JILLIAN YUDIN SLPA

MEDICARE: JILLIAN YUDIN SLPA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12355S0801XSpeech-Language AssistantSPA 1402CA
2235Z00000XSpeech-Language Pathologist16046CA

General Provider Information

NPI Number : 1063766442
Entity Type Code : Individual
Provider Name (Legal Business Name) : JILLIAN YUDIN SLPA
Provider Business Mailing Address
First Line : 1301 E ORANGEWOOD AVE
Second Line :
City : ANAHEIM
State : CA
Zip : 92805-6807
Country : US
Telephone Number : 800-249-1266
Fax Number :
Provider Business Practice Location Address
First Line : 1301 E ORANGEWOOD AVE
Second Line :
City : ANAHEIM
State : CA
Zip : 92805-6807
Country : US
Telephone Number : 800-249-1266
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/06/2012
Last Update Date : 01/03/2022

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Directions to “ JILLIAN YUDIN SLPA” Practice Location

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