Kyle Addison

NPI 1700101540 - Residential Treatment Facility, Emotionally Disturbed Children - 322D00000X

NPI Details
NPI 1700101540
Gender Male
Enumeration Date 04/05/2010
Last Updated 04/05/2010
Entity Type Individual
Active Over 6 years ago
Practice Location
6630 MARYMONTE CT
SAN JOSE CA, 95120-4517, US
Phone (408) 205-8996
Fax
Business Location
1058 S 5TH ST
APT. #201
SAN JOSE CA, 95112-6702, US
Phone (510) 673-2285
Fax
Toxanomy
Taxonomy Code 322D00000X
License State California
License Number 3649
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According to our database, Kyle Addison NPI is 1700101540, taxonomy code is 322D00000X and license number is 3649, license state is located at California. Kyle Addison physically located at 6630 Marymonte Ct, San Jose CA, 95120-4517. NPI Number Kyle Addison has the Individual type.

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1700101540 NPI number is provided on an as is basis without warranty of any kind. 1700101540 is maintained by the National Plan & Provider Enumeration System. The contents of Kyle Addison are for informational purposes only.