Provider Demographics
NPI:1336823350
Name:DULEY, JAKOB ALEXANDER (MS CF-SLP)
Entity Type:Individual
Prefix:MR
First Name:JAKOB
Middle Name:ALEXANDER
Last Name:DULEY
Suffix:
Gender:M
Credentials:MS CF-SLP
Other - Prefix:
Other - First Name:LOREN
Other - Middle Name:JAKOB
Other - Last Name:DULEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:120 MENLO WAY APT 8
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-2158
Mailing Address - Country:US
Mailing Address - Phone:209-327-6798
Mailing Address - Fax:
Practice Address - Street 1:320 N CRAWFORD ST
Practice Address - Street 2:
Practice Address - City:WILLOWS
Practice Address - State:CA
Practice Address - Zip Code:95988-2326
Practice Address - Country:US
Practice Address - Phone:530-934-2834
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program