Provider Demographics
NPI:1851670780
Name:STEPHENS, JODI LYNN (AUD)
Entity Type:Individual
Prefix:
First Name:JODI
Middle Name:LYNN
Last Name:STEPHENS
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7851 WALKER ST
Mailing Address - Street 2:SUITE 206
Mailing Address - City:LA PALMA
Mailing Address - State:CA
Mailing Address - Zip Code:90623-1747
Mailing Address - Country:US
Mailing Address - Phone:714-523-4327
Mailing Address - Fax:714-523-4313
Practice Address - Street 1:7851 WALKER ST
Practice Address - Street 2:SUITE 206
Practice Address - City:LA PALMA
Practice Address - State:CA
Practice Address - Zip Code:90623-1747
Practice Address - Country:US
Practice Address - Phone:714-523-4327
Practice Address - Fax:714-523-4313
Is Sole Proprietor?:No
Enumeration Date:2011-08-09
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU2300237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter