Provider Demographics
NPI:1427460146
Name:ZEPEDA, JESSICA (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:ZEPEDA
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 1:2102 FUENTE DE GOZO
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-6863
Mailing Address - Country:US
Mailing Address - Phone:956-330-9018
Mailing Address - Fax:
Practice Address - Street 1:2102 FUENTE DE GOZO
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-6863
Practice Address - Country:US
Practice Address - Phone:956-330-9018
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-29
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106660235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist