Provider Demographics
NPI:1578514626
Name:SPECTOR, JAMIE TARA (AUD)
Entity Type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:TARA
Last Name:SPECTOR
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:MISS
Other - First Name:JAMIE
Other - Middle Name:TARA
Other - Last Name:STALICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:16111 PLUMMER ST
Mailing Address - Street 2:AUDIOLOGY (126)
Mailing Address - City:NORTH HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91343-2036
Mailing Address - Country:US
Mailing Address - Phone:818-891-7711
Mailing Address - Fax:818-895-5886
Practice Address - Street 1:16111 PLUMMER ST
Practice Address - Street 2:AUDIOLOGY (126)
Practice Address - City:NORTH HILLS
Practice Address - State:CA
Practice Address - Zip Code:91343-2036
Practice Address - Country:US
Practice Address - Phone:818-891-7711
Practice Address - Fax:818-895-5886
Is Sole Proprietor?:No
Enumeration Date:2006-05-13
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU2277231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist