| Mrs Jennifer Marie Wallmark, CCC-SLP | |
|
8 S Cambridge Dr, Lodi, CA 95242-3212 | |
| (209) 327-8788 | |
| Not Available |
| Full Name | Mrs Jennifer Marie Wallmark |
|---|---|
| Gender | Female |
| Speciality | Speech-language Pathologist |
| Location | 8 S Cambridge Dr, Lodi, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255609509 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 235Z00000X | Speech-language Pathologist | 18168 (California) | Primary |
| Provider Name | Permanente Medical Group Inc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1073606299 PECOS PAC ID: 8921910225 Enrollment ID: O20031104000710 |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Jennifer Marie Wallmark, CCC-SLP 8 S Cambridge Dr, Lodi, CA 95242-3212 Ph: (209) 327-8788 | Mrs Jennifer Marie Wallmark, CCC-SLP 8 S Cambridge Dr, Lodi, CA 95242-3212 Ph: (209) 327-8788 |
Mrs. Tamara Leah Lang, MA Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 800 S Ham Ln, Lodi, CA 95242 Phone: 209-368-7141 | |
Colleen Adair Selling, SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1209 W Tokay St, Ste.8, Lodi, CA 95240 Phone: 209-367-8547 | |
Brandee Lyn Smith, MS CCC SLP Speech-Language Pathologist Medicare: Medicare Enrolled Practice Location: 1547 Lexington Dr, Lodi, CA 95242 Phone: 209-663-7238 | |
Carol Kooyman, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 831 So. Lee Ave., Lodi, CA 95240 Phone: 209-747-4304 | |
Ariel Rene Correa, MS, CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1812 W Kettleman Ln Ste 2c, Lodi, CA 95242 Phone: 209-470-2981 | |
Mrs. Sara Marie Peterson, SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1209 W Tokay St, Suite 8, Lodi, CA 95240 Phone: 209-334-0830 | |
Mackenzie Shiba, M.S. CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1812 W Kettleman Ln, Lodi, CA 95242 Phone: 209-242-4606 |