Provider Demographics
NPI:1003170499
Name:JENNINGS, MARGARETHA HANDOKO (MA CCC SLP)
Entity type:Individual
Prefix:MRS
First Name:MARGARETHA
Middle Name:HANDOKO
Last Name:JENNINGS
Suffix:
Gender:F
Credentials:MA CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:10638 COUNTRYSIDE DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-6800
Mailing Address - Country:US
Mailing Address - Phone:909-984-5618
Mailing Address - Fax:
Practice Address - Street 1:950 W D ST
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91762-3026
Practice Address - Country:US
Practice Address - Phone:909-459-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-29
Last Update Date:2025-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18384235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist