Kyle Addison
Kyle Addison is an Emotionally Disturbed Childrens' Residential Treatment Facility in San Jose, California. Practices as a sole proprietor. Licensed in California.
- Licensed in
- CA
- In the registry since
- 2010
Practice location Address checks out
6630 Marymonte CtSan Jose, CA 95120-4517
Phone: (408) 205-8996
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Specialties & licences
| Emotionally Disturbed Childrens' Residential Treatment Facility (primary) | Taxonomy 322D00000X · Licence 3649 (CA) |
|---|
Record details
| NPI number | 1700101540 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | April 5, 2010 |
| Last updated in NPPES | April 5, 2010 |
| Mailing address | 1058 S 5th St, Apt. #201, San Jose, CA 95112-6702 |
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