Basic Information
| Provider Information | |||||||||
| NPI: | 1376963611 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | D'ATTILIO | ||||||||
| FirstName: | JENNIFER | ||||||||
| MiddleName: | |||||||||
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| Credential: | M.S., CCC-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 24600 SILVER CLOUD CT STE 104 | ||||||||
| Address2: | |||||||||
| City: | MONTEREY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 939406555 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8316457900 | ||||||||
| FaxNumber: | 8316457906 | ||||||||
| Practice Location | |||||||||
| Address1: | 24600 SILVER CLOUD CT STE 104 | ||||||||
| Address2: | |||||||||
| City: | MONTEREY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 939406555 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8316457900 | ||||||||
| FaxNumber: | 8316457906 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/25/2014 | ||||||||
| LastUpdateDate: | 05/13/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/13/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | SP 13025 | CA | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.