Healthcare Provider Details

I. General information

NPI: 1578475570
Provider Name (Legal Business Name): JACQUELINE JEANNETTE BARTHOLME MS, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JACQUELINE JEANNETTE DUNN MS, CCC-SLP

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1420 W SAN MARCOS BLVD
SAN MARCOS CA
92078-4017
US

IV. Provider business mailing address

7380 ALTIVA PL
CARLSBAD CA
92009-6421
US

V. Phone/Fax

Practice location:
  • Phone: 760-759-2700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number37507
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: