Provider Demographics
NPI:1649718024
Name:BUCHWALD, JANET S (MA CCC/SLP)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:S
Last Name:BUCHWALD
Suffix:
Gender:F
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 1:1335 SAN CARLOS AVE STE A
Mailing Address - Street 2:
Mailing Address - City:SAN CARLOS
Mailing Address - State:CA
Mailing Address - Zip Code:94070-5604
Mailing Address - Country:US
Mailing Address - Phone:650-619-0757
Mailing Address - Fax:650-344-5079
Practice Address - Street 1:1335 SAN CARLOS AVE STE A
Practice Address - Street 2:
Practice Address - City:SAN CARLOS
Practice Address - State:CA
Practice Address - Zip Code:94070-5604
Practice Address - Country:US
Practice Address - Phone:650-619-0757
Practice Address - Fax:650-344-5079
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-06
Last Update Date:2017-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP101235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist