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NPI Code Detail

MEDICARE: JESSICA BROWN MS, CCC-SLP

MEDICARE:   JESSICA  BROWN  MS, CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist22213CA
2235Z00000XSpeech-Language Pathologist9791FL
3235Z00000XSpeech-Language Pathologist012882OR

General Provider Information

NPI Number : 1124484803
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA BROWN MS, CCC-SLP
Provider Business Mailing Address
First Line : 1661 TEXAS CIR
Second Line :
City : COSTA MESA
State : CA
Zip : 92626-2238
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1661 TEXAS CIR
Second Line :
City : COSTA MESA
State : CA
Zip : 92626-2238
Country : US
Telephone Number : 714-814-1979
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/11/2016
Last Update Date : 01/11/2016

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Directions to “ JESSICA BROWN MS, CCC-SLP” Practice Location

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