Provider Demographics
NPI:1710056767
Name:KEY, JAN CARPENTER (SLP)
Entity Type:Individual
Prefix:MRS
First Name:JAN
Middle Name:CARPENTER
Last Name:KEY
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 1:290 SADDLE LN
Mailing Address - Street 2:
Mailing Address - City:OJAI
Mailing Address - State:CA
Mailing Address - Zip Code:93023-4204
Mailing Address - Country:US
Mailing Address - Phone:805-640-0074
Mailing Address - Fax:805-649-8849
Practice Address - Street 1:11420 N VENTURA AVE
Practice Address - Street 2:
Practice Address - City:OJAI
Practice Address - State:CA
Practice Address - Zip Code:93023-4175
Practice Address - Country:US
Practice Address - Phone:805-649-8849
Practice Address - Fax:805-649-8840
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8236235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist