Provider Demographics
NPI:1538408448
Name:EICHERT, JENNIFER NICOLE (AUD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:NICOLE
Last Name:EICHERT
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:NICOLE
Other - Last Name:GRACE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:500 OLD NEWPORT BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-4234
Mailing Address - Country:US
Mailing Address - Phone:949-642-7935
Mailing Address - Fax:949-642-2950
Practice Address - Street 1:500 OLD NEWPORT BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-4234
Practice Address - Country:US
Practice Address - Phone:949-642-7935
Practice Address - Fax:949-642-2950
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-12
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist