MEDICARE: JESSICA CARDONA SLPA

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	2355S0801X	Speech-Language Assistant	SLPA17138	AZ

General Provider Information

NPI Number	:	1912845710
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA CARDONA SLPA

Provider Business Mailing Address
First Line	:	1322 E LE MARCHE AVE
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85022-3245
Country	:	US
Telephone Number	:	602-283-4121
Fax Number	:	602-283-4184

Provider Business Practice Location Address
First Line	:	1322 E LE MARCHE AVE
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85022-3245
Country	:	US
Telephone Number	:	602-283-4121
Fax Number	:	602-283-4184

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

Provider Enumeration Date	:	03/23/2026
Last Update Date	:	03/23/2026

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Directions to “ JESSICA CARDONA SLPA” Practice Location

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