Provider Demographics
NPI:1831573278
Name:RICE, JASON LOYD (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:LOYD
Last Name:RICE
Suffix:
Gender:M
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 1:38218 CLEAR CREEK ST
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-9353
Mailing Address - Country:US
Mailing Address - Phone:909-744-4082
Mailing Address - Fax:
Practice Address - Street 1:39755 MURRIETA HOT SPRINGS RD STE F120
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-9121
Practice Address - Country:US
Practice Address - Phone:951-894-1600
Practice Address - Fax:951-894-1601
Is Sole Proprietor?:No
Enumeration Date:2015-07-15
Last Update Date:2018-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23354235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACA166721Medicare PIN
CACA166722Medicare PIN
CACA166720Medicare PIN
CACB241269Medicare PIN