Provider Demographics
NPI:1306529649
Name:JAMES, AYESHA KEANNA (MS, CF-SLP)
Entity type:Individual
Prefix:MS
First Name:AYESHA
Middle Name:KEANNA
Last Name:JAMES
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:441 N LAKE ST
Mailing Address - Street 2:
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92544-3314
Mailing Address - Country:US
Mailing Address - Phone:951-927-0822
Mailing Address - Fax:
Practice Address - Street 1:441 N LAKE ST
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92544-3314
Practice Address - Country:US
Practice Address - Phone:951-927-0822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-14
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist