Provider Demographics
NPI:1417152588
Name:PRESLEY, KAREN JUNE (SPEECH LANGUAGE PATH)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:JUNE
Last Name:PRESLEY
Suffix:
Gender:F
Credentials:SPEECH LANGUAGE PATH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4320 STEVENS CREEK BLVD STE 190
Mailing Address - Street 2:EASTER SEALS BAY AREA
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95129-1282
Mailing Address - Country:US
Mailing Address - Phone:408-654-9311
Mailing Address - Fax:408-654-9847
Practice Address - Street 1:4320 STEVENS CREEK BLVD STE 190
Practice Address - Street 2:EASTER SEALS BAY AREA
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95129-1282
Practice Address - Country:US
Practice Address - Phone:408-654-9311
Practice Address - Fax:408-654-9847
Is Sole Proprietor?:No
Enumeration Date:2007-06-19
Last Update Date:2011-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP4082235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL889926600Medicaid