Provider Demographics
NPI:1518665975
Name:LAWRENCE, JOSHUA JAMES (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:JAMES
Last Name:LAWRENCE
Suffix:
Gender:M
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6033 GYPSY MOTH PL
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95123-5367
Mailing Address - Country:US
Mailing Address - Phone:818-438-4377
Mailing Address - Fax:
Practice Address - Street 1:9400 N NAME UNO
Practice Address - Street 2:
Practice Address - City:GILROY
Practice Address - State:CA
Practice Address - Zip Code:95020-3528
Practice Address - Country:US
Practice Address - Phone:408-848-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-15
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27150235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist