Provider Demographics
NPI:1457551863
Name:CAPUTO, JEAN (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:
Last Name:CAPUTO
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 1:5720 SIMPSON AVE
Mailing Address - Street 2:
Mailing Address - City:VALLEY VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91607-1329
Mailing Address - Country:US
Mailing Address - Phone:310-880-0456
Mailing Address - Fax:818-980-7082
Practice Address - Street 1:8635 W 3RD ST
Practice Address - Street 2:SUITE 685 WEST
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-6101
Practice Address - Country:US
Practice Address - Phone:310-880-0456
Practice Address - Fax:818-980-7082
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-23
Last Update Date:2007-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13955235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist