Provider Demographics
NPI:1225257181
Name:TRIMBLE, JARED PAUL (MS, CCC-A, FAAA)
Entity Type:Individual
Prefix:
First Name:JARED
Middle Name:PAUL
Last Name:TRIMBLE
Suffix:
Gender:M
Credentials:MS, CCC-A, FAAA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10233 W DALEY LN
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85383-2737
Mailing Address - Country:US
Mailing Address - Phone:623-505-3160
Mailing Address - Fax:
Practice Address - Street 1:13934 N 59TH AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85306-4167
Practice Address - Country:US
Practice Address - Phone:602-866-0147
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZDA4680231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist