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NPI Code Detail

MEDICARE: JENNIFER PASTORES

MEDICARE: JENNIFER PASTORES
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 Pathologist3353AL
2235Z00000XSpeech-Language Pathologist07895MD
3235Z00000XSpeech-Language Pathologist12369AZ

General Provider Information

NPI Number : 1386169993
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER PASTORES
Provider Business Mailing Address
First Line : 1001 N PASADENA UNIT 44
Second Line :
City : MESA
State : AZ
Zip : 85201-3520
Country : US
Telephone Number : 256-658-8716
Fax Number :
Provider Business Practice Location Address
First Line : 2225 W SOUTHERN AVE STE B
Second Line :
City : MESA
State : AZ
Zip : 85202-4716
Country : US
Telephone Number : 623-888-3502
Fax Number : 480-795-6161
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/04/2017
Last Update Date : 10/18/2024

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Directions to “ JENNIFER PASTORES ” 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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