Provider Demographics
NPI:1205070257
Name:LOOMIS, JENE' CHRISTINE (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:JENE'
Middle Name:CHRISTINE
Last Name:LOOMIS
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1855 MEINERS RD
Mailing Address - Street 2:
Mailing Address - City:OJAI
Mailing Address - State:CA
Mailing Address - Zip Code:93023-1625
Mailing Address - Country:US
Mailing Address - Phone:805-646-8609
Mailing Address - Fax:805-646-8633
Practice Address - Street 1:1855 MEINERS RD
Practice Address - Street 2:
Practice Address - City:OJAI
Practice Address - State:CA
Practice Address - Zip Code:93023-1625
Practice Address - Country:US
Practice Address - Phone:805-646-8609
Practice Address - Fax:805-646-8633
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-21
Last Update Date:2009-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA9403235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist