Provider Demographics
NPI:1740629518
Name:CRESPO, JENNIFER MELISSA (MA)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:MELISSA
Last Name:CRESPO
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 SHUMAN BLVD STE 401
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-8123
Mailing Address - Country:US
Mailing Address - Phone:630-303-5380
Mailing Address - Fax:630-303-5385
Practice Address - Street 1:411 E HUNTINGTON DR STE 121
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-3788
Practice Address - Country:US
Practice Address - Phone:626-574-3138
Practice Address - Fax:626-574-3195
Is Sole Proprietor?:No
Enumeration Date:2013-06-14
Last Update Date:2019-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU 2663237600000X
CAAU2663231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter