Provider Demographics
NPI:1245663004
Name:ARNALDO, JEANINE (CCC, SLP)
Entity type:Individual
Prefix:
First Name:JEANINE
Middle Name:
Last Name:ARNALDO
Suffix:
Gender:F
Credentials: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:PO BOX 893337
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92589-3337
Mailing Address - Country:US
Mailing Address - Phone:855-452-3784
Mailing Address - Fax:855-452-3784
Practice Address - Street 1:41421 DATE ST STE 101
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-7079
Practice Address - Country:US
Practice Address - Phone:855-454-3784
Practice Address - Fax:855-454-3784
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-15
Last Update Date:2013-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP 11412235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist