Provider Demographics
NPI:1568855021
Name:JUMP AND SCHOUT THERAPY
Entity Type:Organization
Organization Name:JUMP AND SCHOUT THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LEANN
Authorized Official - Middle Name:D
Authorized Official - Last Name:SCHOUTEN
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:714-529-5022
Mailing Address - Street 1:500 W. CENTRAL AVE. SUITE B
Mailing Address - Street 2:
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92821-3036
Mailing Address - Country:US
Mailing Address - Phone:714-529-5022
Mailing Address - Fax:714-529-5016
Practice Address - Street 1:500 W. CENTRAL AVE. SUITE B
Practice Address - Street 2:
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821-3036
Practice Address - Country:US
Practice Address - Phone:714-529-5022
Practice Address - Fax:714-529-5016
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-09
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
CA8428225X00000X
CA12231235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty