Healthcare Provider Details

I. General information

NPI: 1902733819
Provider Name (Legal Business Name): JESSICA SABIDO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44910 17TH ST E
LANCASTER CA
93535-2744
US

IV. Provider business mailing address

45214 STADIUM CT
LANCASTER CA
93535-2478
US

V. Phone/Fax

Practice location:
  • Phone: 166-194-9317
  • Fax:
Mailing address:
  • Phone: 818-640-5567
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: