Healthcare Provider Details

I. General information

NPI: 1225926785
Provider Name (Legal Business Name): LEARN BY DESIGN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2025
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3720 PAYNE AVE
SAN JOSE CA
95117-3412
US

IV. Provider business mailing address

3720 PAYNE AVE
SAN JOSE CA
95117-3412
US

V. Phone/Fax

Practice location:
  • Phone: 408-218-6533
  • Fax: 855-582-6692
Mailing address:
  • Phone: 408-218-6533
  • Fax: 855-582-6692

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL

VIII. Authorized Official

Name: KAYLA MARIE WALLACE
Title or Position: DIRECTOR OF CLINICAL SERVICES
Credential: BCBA
Phone: 408-218-6533