Provider Demographics
NPI:1801329305
Name:MARQUARDT, JODEE (MS-CCC/SLP)
Entity type:Individual
Prefix:
First Name:JODEE
Middle Name:
Last Name:MARQUARDT
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 1:123 W PADRE ST
Mailing Address - Street 2:STE F
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-3960
Mailing Address - Country:US
Mailing Address - Phone:805-407-2048
Mailing Address - Fax:
Practice Address - Street 1:123 W PADRE ST
Practice Address - Street 2:STE F
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-3960
Practice Address - Country:US
Practice Address - Phone:805-407-2048
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-11
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11393235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist