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NPI Code Detail

MEDICARE: JALISA PATRICE HUGLEY

MEDICARE: JALISA PATRICE HUGLEY
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 AssistantSPA3595CA

General Provider Information

NPI Number : 1831523992
Entity Type Code : Individual
Provider Name (Legal Business Name) : JALISA PATRICE HUGLEY
Provider Business Mailing Address
First Line : 1221 W 3RD ST APT 606
Second Line :
City : LOS ANGELES
State : CA
Zip : 90017-5195
Country : US
Telephone Number : 954-899-5072
Fax Number : 954-899-5072
Provider Business Practice Location Address
First Line : 3521 LOMITA BLVD STE 201
Second Line :
City : TORRANCE
State : CA
Zip : 90505-5040
Country : US
Telephone Number : 310-856-8528
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/26/2013
Last Update Date : 07/21/2022

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Directions to “ JALISA PATRICE HUGLEY ” Practice Location

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