Healthcare Provider Details

I. General information

NPI: 1114567765
Provider Name (Legal Business Name): CRANIAL TECHNOLOGIES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2020
Last Update Date: 08/24/2021
Certification Date: 08/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 SOUTH DR STE 23
MOUNTAIN VIEW CA
94040-4209
US

IV. Provider business mailing address

1405 W AUTO DR FL 2
TEMPE AZ
85284-1016
US

V. Phone/Fax

Practice location:
  • Phone: 844-447-5894
  • Fax: 844-447-5895
Mailing address:
  • Phone: 480-403-6374
  • Fax: 844-447-5895

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: TAMMY JONES
Title or Position: NATIONAL FACILITIES DIRECTOR
Credential:
Phone: 480-403-6330