Provider Demographics
NPI:1740516590
Name:SCHOOL OF IMAGINATION
Entity type:Organization
Organization Name:SCHOOL OF IMAGINATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MITCHELL
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:SIGMAN
Authorized Official - Suffix:
Authorized Official - Credentials:ATC
Authorized Official - Phone:925-829-9555
Mailing Address - Street 1:9801 DUBLIN BLVD
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-2835
Mailing Address - Country:US
Mailing Address - Phone:925-829-9555
Mailing Address - Fax:
Practice Address - Street 1:9801 DUBLIN BLVD
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:CA
Practice Address - Zip Code:94568-2835
Practice Address - Country:US
Practice Address - Phone:925-829-9555
Practice Address - Fax:925-236-9712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-29
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty