Provider Demographics
NPI:1669536074
Name:ROSS, JAMIE MARIE (AUD)
Entity type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:MARIE
Last Name:ROSS
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 1:39360 SUMMERWIND DR
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93551-4082
Mailing Address - Country:US
Mailing Address - Phone:661-947-9861
Mailing Address - Fax:661-947-4692
Practice Address - Street 1:39360 SUMMERWIND DR
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93551-4082
Practice Address - Country:US
Practice Address - Phone:661-947-9861
Practice Address - Fax:661-947-4692
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU1310231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist