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NPI Code Detail

MEDICARE: JENNIFER LYNN FARRELL MS CCC-SLP

MEDICARE: JENNIFER LYNN FARRELL 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 PathologistSLP5405AZ
2235Z00000XSpeech-Language PathologistSP 15824CA

General Provider Information

NPI Number : 1881714152
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER LYNN FARRELL MS CCC-SLP
Provider Business Mailing Address
First Line : 18350 MOUNT LANGLEY ST
Second Line : #105
City : FOUNTAIN VALLEY
State : CA
Zip : 92708-6900
Country : US
Telephone Number : 714-965-2324
Fax Number : 714-965-2684
Provider Business Practice Location Address
First Line : 5312 BOLSA AVE STE 105
Second Line :
City : HUNTINGTON BEACH
State : CA
Zip : 92649-1060
Country : US
Telephone Number : 714-965-2324
Fax Number : 818-241-6853
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2007
Last Update Date : 06/17/2020

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Directions to “ JENNIFER LYNN FARRELL MS CCC-SLP” Practice Location

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