MEDICARE: ASPIRANET

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD1600X	Developmental Disabilities Clinic/Center	MFC 51268	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	51268	OTHER	CA	LMFC

General Provider Information

NPI Number	:	1750625505
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASPIRANET

Provider Business Mailing Address
First Line	:	588 BLOSSOM HILL RD
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95123-3200
Country	:	US
Telephone Number	:	408-728-0486
Fax Number	:	408-629-5709

Provider Business Practice Location Address
First Line	:	588 BLOSSOM HILL RD
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95123-3200
Country	:	US
Telephone Number	:	408-728-0486
Fax Number	:	408-629-5709

Authorized Official
Title or Position	:	COMPANY OFFICER
Name	:	MR. WESTON LANGE I
Credential	:	LCSW
Telephone Number	:	209-668-6188

Provider Enumeration Date	:	11/18/2012
Last Update Date	:	11/18/2012

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Directions to “ASPIRANET ” Practice Location

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