1639181571 NPI number — PROGRESSIVE SPEECH CORP.

Table of content: MS. YVONNE SUZANNE KRAMER RN (NPI 1891824629)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639181571 NPI number — PROGRESSIVE SPEECH CORP.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PROGRESSIVE SPEECH CORP.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1639181571
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3190 S BASCOM AVE
Provider Second Line Business Mailing Address:
SUITE 150
Provider Business Mailing Address City Name:
SAN JOSE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95124-2569
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
408-377-3064
Provider Business Mailing Address Fax Number:
408-377-3058

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3190 S BASCOM AVE
Provider Second Line Business Practice Location Address:
SUITE 150
Provider Business Practice Location Address City Name:
SAN JOSE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95124-2569
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
408-377-3064
Provider Business Practice Location Address Fax Number:
408-377-3058
Provider Enumeration Date:
08/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BOSTON
Authorized Official First Name:
DAWN
Authorized Official Middle Name:
L.
Authorized Official Title or Position:
SPEECH-LANGUAGE PATHOLOGIST
Authorized Official Telephone Number:
408-377-3064

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  11819 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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