Jacqueline Klein, MA, CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · Encino, CA
NPI 1619260957 · NPPES record last updated Nov 19, 2024
Key facts
- NPI
- 1619260957
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 18261 (CA)
- Practice address
- 5401 Zelzah Ave Apt 111
Encino, CA 91316-2204 - Phone
- (323) 833-7863
- NPI assigned
- May 19, 2011
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 021942 | NY | MD | Speech-Language Pathologist |
| 18261 | CA | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| J. Gudis Speech and Language | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 021942 | NY | |
| Speech-Language Pathologist | 235Z00000X | 18261 | CA | Yes |
Addresses
Primary practice location
5401 Zelzah Ave Apt 111
Encino, CA 91316-2204
Mailing address
5401 Zelzah Ave Apt 111
Encino, CA 91316-2204
Phone (323) 833-7863
Other providers in Encino, CA
- Gerald M Kirshbaum
- Bernard Kirzner
- Chanisara Kitpetnee
- Julie Klamon
- Allan H Klass
- Jeffrey Howard Klein
- Russell A Klein
- Richard Ludwig Kleinberger
- Bridget Kathleen Kleinert
- Jill Klepetar
All providers in Encino, CA · Speech-Language Pathologist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 19, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.