Jenica Dawn Herndon, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

LL61595760 Issued in WA

Practice address

18360 Caldart Ave NE
Poulsbo, WA 98370-8775

Phone

(360) 396-3788

NPI assigned

Nov 7, 2024

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1730937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730937600000",
    "number": "1821811787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18360 CALDART AVE NE",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983708775",
            "telephone_number": "360-396-3788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18360 CALDART AVE NE",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983708775",
            "telephone_number": "360-396-3788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNDON",
        "first_name": "JENICA",
        "middle_name": "DAWN",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-07",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL61595760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Manfred Henne, MD
• June Marie Hensley, M.A.
• Amber Henson, RN
• Heritage Health Center Inc
• Janine Hernandez, SUDP
• Andrea B Hickman, M.ED, LMHC
• Myrna L Hill, M.A., LMFT
• Calli Elizabeth Hilvitz, M.S., CF-SLP
• Mark C Hoffman, MD
• Holistic Family Practice, Inc

• Speech-Language Pathologist in Poulsbo, WA
• Providers in Poulsbo, WA by specialty
• Speech-Language Pathologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2024; 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.