Jessica Detten, M.S.,CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP12499 Issued in AZ

Practice address

418 E Main St
Springerville, AZ 85938-5220

Phone

(928) 333-6800

NPI assigned

Aug 25, 2015

Last updated

Jan 10, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1440460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673308800000",
    "number": "1710354733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 668",
            "city": "HOLBROOK",
            "state": "AZ",
            "postal_code": "860250668",
            "telephone_number": "928-524-2123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 E MAIN ST",
            "city": "SPRINGERVILLE",
            "state": "AZ",
            "postal_code": "859385220",
            "telephone_number": "928-333-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETTEN",
        "first_name": "JESSICA",
        "credential": "M.S.,CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-25",
        "last_updated": "2023-01-10",
        "certification_date": "2023-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "SLP12499",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASHA",
            "identifier": "14065279",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZ DEPT OF ED",
            "identifier": "6138712",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZ DEPT OF HEALTH SERVICES",
            "identifier": "SLP12499",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joshua David Burton, PHARMD.
• Comfort Cruise Non-Emergency Medical Transportation LLC
• Community Bridges, Inc. (LCBH Springerville OP Adolescent Program)
• County of Apache
• Val J Crane, RPH
• Mary Rebecca Difilippo, NMD
• El Rio Santa Cruz Neighborhood Health Center, Inc. (Elk Ridge Springerville)
• Ramsey Finch, NP
• Guardian Flight LLC
• Steven Shumway Hamblin, PT

• Speech-Language Pathologist in Springerville, AZ
• Providers in Springerville, AZ by specialty
• Speech-Language Pathologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.