Provider Demographics
NPI:1780370064
Name:VELASCO, JEIMS (HCP)
Entity type:Individual
Prefix:MR
First Name:JEIMS
Middle Name:
Last Name:VELASCO
Suffix:
Gender:M
Credentials:HCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27200 TOURNEY RD STE 290
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-5906
Mailing Address - Country:US
Mailing Address - Phone:909-353-5508
Mailing Address - Fax:
Practice Address - Street 1:27200 TOURNEY RD STE 290
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-5906
Practice Address - Country:US
Practice Address - Phone:909-353-5508
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-11
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA-8674237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist