Provider Demographics
NPI:1942622485
Name:JOY & LAUGHTER DEVELOPMENTAL THERAPY
Entity Type:Organization
Organization Name:JOY & LAUGHTER DEVELOPMENTAL THERAPY
Other - Org Name:JLD THERAPY
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:408-337-2727
Mailing Address - Street 1:1400 COLEMAN AVE
Mailing Address - Street 2:SUITE B24
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95050-4309
Mailing Address - Country:US
Mailing Address - Phone:408-337-2727
Mailing Address - Fax:
Practice Address - Street 1:1400 COLEMAN AVE
Practice Address - Street 2:SUITE B24
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95050-4309
Practice Address - Country:US
Practice Address - Phone:408-337-2727
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-18
Last Update Date:2014-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency