Provider Demographics
NPI:1952293060
Name:GAYTAN, JEANNETTE KARLA
Entity type:Individual
Prefix:
First Name:JEANNETTE
Middle Name:KARLA
Last Name:GAYTAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7817 HERMOSILLO DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79915-2701
Mailing Address - Country:US
Mailing Address - Phone:915-240-3008
Mailing Address - Fax:
Practice Address - Street 1:2400 ZANZIBAR RD
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-5424
Practice Address - Country:US
Practice Address - Phone:915-434-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-15
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX122866235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist