Provider Demographics
NPI:1578309894
Name:JAHNKOW, CASSANDRA ELLE (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:ELLE
Last Name:JAHNKOW
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 1:8821 BELMONT ST
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:CA
Mailing Address - Zip Code:90630-2111
Mailing Address - Country:US
Mailing Address - Phone:715-851-4866
Mailing Address - Fax:
Practice Address - Street 1:3777 LONG BEACH BLVD STE 400
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-3341
Practice Address - Country:US
Practice Address - Phone:562-317-5030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-05
Last Update Date:2024-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30888235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist