Healthcare Provider Details

I. General information

NPI: 1730903105
Provider Name (Legal Business Name): JAIME NARANJO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/13/2024
Last Update Date: 11/13/2024
Certification Date: 11/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12411 SLAUSON AVE STE G
WHITTIER CA
90606-2835
US

IV. Provider business mailing address

12411 SLAUSON AVE STE G
WHITTIER CA
90606-2835
US

V. Phone/Fax

Practice location:
  • Phone: 562-693-5449
  • Fax: 562-693-5469
Mailing address:
  • Phone: 562-693-5449
  • Fax: 562-693-5469

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: