Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
KYLE ADDISON
Active Sole ProprietorResidential Treatment, Emotionally Disturbed Children · SAN JOSE, CA
Registration Details
- NPI Number
- 1700101540
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Apr 5, 2010 (16.046105567286 yrs)
- Last Updated
- Apr 5, 2010
- License
-
3649 (CA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
6630 MARYMONTE CTSAN JOSE, CA, 951204517Browse CA providers · Browse ZIP 95120
- Phone
- 4082058996
- Primary Specialty
-
Residential Treatment, Emotionally Disturbed Children
322D00000X
Other Residential Treatment, Emotionally Disturbed Children Providers in SAN JOSE, CA
| Name | Credential | NPI |
|---|---|---|
| MISS JENNIFER MARIE CRANE | MFTI | 1255475497 |
| LINDSAY MARIE BLACKWELL | — | 1134316722 |
| MRS. DEBRA LEE COLLINS | R.N. | 1013197052 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.