Organization
KIDANGO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALISSON ELLWOOD (SUPERVISOR)
(510) 565-0837
Entity
Organization
Contact information
Practice address
44000 OLD WARM SPRINGS BLVD, FREMONT, CA 94538-6145
(510) 565-0837
Mailing address
44000 OLD WARM SPRINGS BLVD, FREMONT, CA 94538-6145
(510) 565-0837
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
252Y00000X
CA
Other
Enumeration date
09/07/2010
Last updated
09/07/2010
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