NPIMap

Organization Active NPI

JLD All-Stars

  • Developmental Disabilities Clinic/Center
  • San Jose, CA
National Provider Identifier
1053941989
Registry record updated Jan 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X
Legal business name
JLD ALL-STARS
Practice address
826 N Winchester Blvd Ste 2G
San Jose, CA 95128-1357
Phone
(408) 337-2727
Fax
(408) 478-4130
NPI assigned
Jan 20, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jennifer L Davis, MS, OTR/LNPI 1609110063
Title
Ower/Operator
Phone
(408) 337-2727

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225X00000X
Feeding, Eating & Swallowing Occupational TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225XF0002X
Pediatric Occupational TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225XP0200X
Speech-Language PathologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 235Z00000X
Early Intervention Provider Agency 252Y00000X
Developmental Disabilities Clinic/Center 261QD1600X Primary

Addresses

Primary practice location

826 N Winchester Blvd Ste 2G
San Jose, CA 95128-1357

Mailing address

826 N Winchester Blvd Ste 2G
San Jose, CA 95128-1357
Phone (408) 337-2727

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1579478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579478400000",
    "number": "1053941989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "826 N WINCHESTER BLVD STE 2G",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951281357",
            "telephone_number": "408-337-2727",
            "fax_number": "408-478-4130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "826 N WINCHESTER BLVD STE 2G",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951281357",
            "telephone_number": "408-337-2727",
            "fax_number": "408-478-4130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JLD ALL-STARS",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-20",
        "last_updated": "2020-01-20",
        "certification_date": "2020-01-20",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWER/OPERATOR",
        "authorized_official_telephone_number": "408-337-2727",
        "authorized_official_credential": "MS, OTR/L"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XF0002X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Occupational Therapist, Feeding, Eating & Swallowing",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.