Provider Demographics
NPI:1225369416
Name:HIGGINS, JAYNE C (SLP)
Entity Type:Individual
Prefix:
First Name:JAYNE
Middle Name:C
Last Name:HIGGINS
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16782 VON KARMAN AVE
Mailing Address - Street 2:SUITE 11
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92606-9928
Mailing Address - Country:US
Mailing Address - Phone:949-833-2237
Mailing Address - Fax:949-833-2230
Practice Address - Street 1:16782 VON KARMAN AVE
Practice Address - Street 2:SUITE 11
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92606-9928
Practice Address - Country:US
Practice Address - Phone:949-833-2237
Practice Address - Fax:949-833-2230
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-27
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA882235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist