Healthcare Provider Details

I. General information

NPI: 1225369416
Provider Name (Legal Business Name): JAYNE C. HIGGINS SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/27/2010
Last Update Date: 01/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16782 VON KARMAN AVE SUITE 11
IRVINE CA
92606-9928
US

IV. Provider business mailing address

16782 VON KARMAN AVE SUITE 11
IRVINE CA
92606-9928
US

V. Phone/Fax

Practice location:
  • Phone: 949-833-2237
  • Fax: 949-833-2230
Mailing address:
  • Phone: 949-833-2237
  • Fax: 949-833-2230

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number882
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: