MEDICARE: HIGH TIDE SPEECH AND LANGUAGE THERAPY

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
1	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1265367288
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HIGH TIDE SPEECH AND LANGUAGE THERAPY

Provider Business Mailing Address
First Line	:	244 SANDCASTLE
Second Line	:
City	:	ALISO VIEJO
State	:	CA
Zip	:	92656-3839
Country	:	US
Telephone Number	:	949-842-4535
Fax Number	:

Provider Business Practice Location Address
First Line	:	244 SANDCASTLE
Second Line	:
City	:	ALISO VIEJO
State	:	CA
Zip	:	92656-3839
Country	:	US
Telephone Number	:	949-842-4535
Fax Number	:

Authorized Official
Title or Position	:	SPEECH AND LANGUAGE PATHOLOGIST
Name	:	MS. MONICA LEA JESSEN
Credential	:	M.S., CCC-SLP
Telephone Number	:	949-842-4535

Provider Enumeration Date	:	06/13/2026
Last Update Date	:	06/13/2026

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Directions to “HIGH TIDE SPEECH AND LANGUAGE THERAPY ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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