Individual
JACOB JONAH LASCANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S., CCC-SLP
Contact information
Practice address
4647 ZION AVE, SAN DIEGO, CA 92120-2507
(833) 574-2273
Mailing address
3200 PASEO VILLAGE WAY APT 1715, SAN DIEGO, CA 92130-3248
(347) 684-8759
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
14344069
CA
Other
Enumeration date
03/04/2024
Last updated
03/04/2024
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