Organization
MIND BY DESIGN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANA PARKER LEP (PRESIDENT/ LEP)
(669) 282-2510
Entity
Organization
Contact information
Practice address
51 E CAMPBELL AVE STE 109, CAMPBELL, CA 95008-2047
(669) 282-2510
Mailing address
51 E CAMPBELL AVE STE 109, CAMPBELL, CA 95008-2047
(669) 282-2510
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
103TS0200X
School Psychologist
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
235Z00000X
Speech-Language Pathologist
—
—
261QH0700X
Hearing and Speech Clinic/Center
—
—
Other
Enumeration date
06/12/2023
Last updated
06/12/2023
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