Healthcare Provider Details

I. General information

NPI: 1114875762
Provider Name (Legal Business Name): JOELLE EARLE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/19/2026
Last Update Date: 03/19/2026
Certification Date: 03/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 S KING RD STE 40
SAN JOSE CA
95122-2140
US

IV. Provider business mailing address

4750 ALMADEN EXPY STE 124
SAN JOSE CA
95118-2052
US

V. Phone/Fax

Practice location:
  • Phone: 408-622-9222
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number863404041
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: