Healthcare Provider Details

I. General information

NPI: 1225196280
Provider Name (Legal Business Name): THE GREAT TALKING BOX COMPANY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2245 FORTUNE DR STE A
SAN JOSE CA
95131-1867
US

IV. Provider business mailing address

2245 FORTUNE DR STE A
SAN JOSE CA
95131-1867
US

V. Phone/Fax

Practice location:
  • Phone: 408-456-0133
  • Fax: 408-456-0134
Mailing address:
  • Phone: 408-456-0133
  • Fax: 408-456-0134

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number101012
License Number StateCA

VIII. Authorized Official

Name: MR. ED M KANDEFER
Title or Position: PRESIDENT
Credential:
Phone: 408-456-0133