Organization
PLAYDATES. SOFT INDOOR PLAYLOUNGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE BUTLER EDUCATION SPECIALIST (OWNER)
(415) 637-7616
Entity
Organization
Contact information
Practice address
2092 OMEGA RD STE G, SAN RAMON, CA 94583-1230
(415) 637-7616
Mailing address
1210 ACACIA DR, HAYWARD, CA 94541-5205
(415) 637-7616
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
—
—
2355S0801X
Speech-Language Assistant
—
—
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
12/09/2024
Last updated
12/09/2024
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