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General NPI Number Information
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NPI Number | 1922752385
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Entity Type | Individual
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Provider Name | JASMIN J HERRERA
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Gender | Female
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Dates
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Enumeration Date | 02/04/2022
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Last Update Date | 02/04/2022
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Provider Practice Location Address
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Address Line | 20435 S OLD ELLSWORTH RD
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City | QUEEN CREEK
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State | AZ
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Zip | 85142-9676
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Country | US
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Telephone | 480-987-5940
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Fax |
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Provider Business Mailing Address
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Address Line | 41629 N RANCH DR
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City | SAN TAN VALLEY
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State | AZ
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Zip | 85140-3206
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Country | US
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Telephone | 773-818-1498
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number | 217000405
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number | SLPA13421
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License Number State | AZ
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