MEDICARE: JESSICA WEIGAND M.S., 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
1	235Z00000X	Speech-Language Pathologist	7101005827	MI
2	235Z00000X	Speech-Language Pathologist	31394	CA

General Provider Information

NPI Number	:	1639669450
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA WEIGAND M.S., CCC-SLP

Provider Business Mailing Address
First Line	:	75100 MEDITERRANEAN
Second Line	:
City	:	PALM DESERT
State	:	CA
Zip	:	92211-9069
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	41555 COOK ST STE 100
Second Line	:
City	:	PALM DESERT
State	:	CA
Zip	:	92211-5184
Country	:	US
Telephone Number	:	760-837-0033
Fax Number	:	760-837-1013

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/17/2018
Last Update Date	:	04/15/2026

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Directions to “ JESSICA WEIGAND M.S., CCC-SLP” Practice Location

Language	Start Address	Practice Location

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