Organization
JLD ALL-STARS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER L DAVIS MS, OTR/L (OWER/OPERATOR)
(408) 337-2727
Entity
Organization
Contact information
Practice address
826 N WINCHESTER BLVD STE 2G, SAN JOSE, CA 95128-1357
(408) 337-2727
(408) 478-4130
Mailing address
826 N WINCHESTER BLVD STE 2G, SAN JOSE, CA 95128-1357
(408) 337-2727
(408) 478-4130
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
—
—
225XF0002X
Feeding, Eating & Swallowing Occupational Therapist
—
—
225XP0200X
Pediatric Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
252Y00000X
Early Intervention Provider Agency
—
—
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Enumeration date
01/20/2020
Last updated
01/20/2020
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