Provider Demographics
NPI:1164787800
Name:ROCKETSHIP EDUCATION
Entity Type:Organization
Organization Name:ROCKETSHIP EDUCATION
Other - Org Name:ROCKETSHIP LOS SUENOS ACADEMY
Other - Org Type:Other Name
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:CHICHI
Authorized Official - Middle Name:
Authorized Official - Last Name:CHIDI
Authorized Official - Suffix:
Authorized Official - Credentials:MA,CCC-SLP
Authorized Official - Phone:408-338-7634
Mailing Address - Street 1:420 FLORENCE ST
Mailing Address - Street 2:STE. 300
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94301-1741
Mailing Address - Country:US
Mailing Address - Phone:877-806-0920
Mailing Address - Fax:
Practice Address - Street 1:331 S 34TH ST
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-2905
Practice Address - Country:US
Practice Address - Phone:877-806-0920
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-09
Last Update Date:2012-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)