Healthcare Provider Details

I. General information

NPI: 1689583809
Provider Name (Legal Business Name): JODI PARKINSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

608 PINAL AVE # 93455
ORCUTT CA
93455-5302
US

IV. Provider business mailing address

556 MARGIE PL
NIPOMO CA
93444-5623
US

V. Phone/Fax

Practice location:
  • Phone: 805-938-8700
  • Fax:
Mailing address:
  • Phone: 559-909-2190
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number39820
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: