Provider Demographics
NPI:1306478912
Name:HEIN, JOANNE GERSTEIN (MS, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:JOANNE
Middle Name:GERSTEIN
Last Name:HEIN
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 1:4858 MERCURY ST STE 106
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-2128
Mailing Address - Country:US
Mailing Address - Phone:619-997-4346
Mailing Address - Fax:858-560-1034
Practice Address - Street 1:4858 MERCURY ST STE 106
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-2128
Practice Address - Country:US
Practice Address - Phone:619-997-4346
Practice Address - Fax:858-560-1034
Is Sole Proprietor?:No
Enumeration Date:2020-02-11
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
235Z00000X
CACA3397235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACA3397OtherCALIFORNIA SPEECH-LANGUAGE-HEARING ASSOCIATION
ASHA00554444OtherAMERICAN SPEECH-LANGUAGE-HEARING ASSOCIATION