NPI 1700101540
Kyle Addison
Practice location
- Address
- 6630 Marymonte CT, San Jose, CA 95120-4517
- Phone
- (408) 205-8996
- Mailing address
- 1058 S 5th St APT. #201, San Jose, CA 95112-6702
Registered specialties
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
Registry record
- NPI
- 1700101540
- Entity type
- Individual
- Sex (as registered)
- Male
- NPI issued
- 5 Apr 2010
- Record last updated
- 5 Apr 2010
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.