Individual
CHRISTINE BACON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
540 COAKLEY DR, SAN JOSE, CA 95117-1522
(408) 921-6863
Mailing address
540 COAKLEY DR, SAN JOSE, CA 95117-1522
(408) 921-6863
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3840
—
Other
Enumeration date
03/29/2023
Last updated
03/29/2023
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