MEDICARE: MELISSA M JENNINGS MS

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
1	235Z00000X	Speech-Language Pathologist	SP-40115	CA

General Provider Information

NPI Number	:	1972021459
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA M JENNINGS MS

Provider Business Mailing Address
First Line	:	295 89TH ST
Second Line	:
City	:	DALY CITY
State	:	CA
Zip	:	94015-1653
Country	:	US
Telephone Number	:	925-222-5353
Fax Number	:

Provider Business Practice Location Address
First Line	:	295 89TH ST
Second Line	:
City	:	DALY CITY
State	:	CA
Zip	:	94015-1653
Country	:	US
Telephone Number	:	925-222-5353
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/05/2017
Last Update Date	:	12/21/2025

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