Provider Demographics
NPI:1932791936
Name:KIPP, HEATHER K (BA, SLPA)
Entity Type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:K
Last Name:KIPP
Suffix:
Gender:F
Credentials:BA, SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20162 SW BIRCH ST STE 350
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-0790
Mailing Address - Country:US
Mailing Address - Phone:714-316-8310
Mailing Address - Fax:949-610-7660
Practice Address - Street 1:20162 SW BIRCH ST STE 350
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-0790
Practice Address - Country:US
Practice Address - Phone:714-316-8310
Practice Address - Fax:949-610-7660
Is Sole Proprietor?:No
Enumeration Date:2021-02-10
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant