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General NPI Number Information
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NPI Number | 1124378203
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Entity Type | Organization
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Legal Business Name | JSS CONSULTING, INC.
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Dates
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Enumeration Date | 09/14/2012
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Last Update Date | 03/25/2015
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Provider Practice Location Address
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Address Line | 4140 CAPITOLA RD STE. R
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City | CAPITOLA
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State | CA
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Zip | 95010-2571
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Country | US
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Telephone | 831-498-9890
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Fax | 831-708-1333
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Provider Business Mailing Address
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Address Line | 4140 CAPITOLA RD STE. R
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City | CAPITOLA
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State | CA
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Zip | 95010-2571
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Country | US
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Telephone | 831-498-9890
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Fax | 831-708-1333
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Authorized Official
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Title or Position | PRESIDENT
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Name | JUSTIN STACK
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Credential | HA-7393
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Telephone | 415-314-1415
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number | 7393
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License Number State | CA
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