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Organization
PEDIATRIC THERAPY SERVICES
Active
Organization
PEDIATRIC THERAPY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHRISTINE MORRIS BACON M.A. CCC SLP (DIRECTOR OF SERVICES , OWNER)
(408) 358-8330
Entity
Organization
Contact information
Practice address
2577 SAMARITAN DR, SUITE 715, SAN JOSE, CA 95124-4100
(408) 358-8330
(408) 358-8334
Mailing address
2577 SAMARITAN DR, SUITE 715, SAN JOSE, CA 95124-4100
(408) 358-8330
(408) 904-7178
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
04/16/2007
Last updated
08/08/2016
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