Juancho Miguel San Pedro

Primary specialty

Speech-Language AssistantTaxonomy code 2355S0801X

Practice address

911 Bern CT Ste 130
San Jose, CA 95112-1242

Phone

(408) 437-8864

NPI assigned

Jul 6, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Jay San Pedro Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• County of Santa Clara

  • General Acute Care Hospital
  • San Jose, CA
  • NPI 1063406551
  NPD (past)
• Integrated Intervention for Children With Autism

  • Speech-Language Pathologist
  • San Jose, CA
  • NPI 1669725834
  NPD (past)

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

{
    "created_epoch": "1625529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683158400000",
    "number": "1093386542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 BERN CT STE 130",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951121242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 BERN CT STE 130",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951121242",
            "telephone_number": "408-437-8864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAN PEDRO",
        "first_name": "JUANCHO",
        "middle_name": "MIGUEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-07-06",
        "last_updated": "2023-05-04",
        "certification_date": "2023-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAY",
            "last_name": "SAN PEDRO",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• San Jose Womens Medical Group Inc
• San Jose/Evergreen Community College District
• Carlos Manuel Angeles San Mateo, MD
• Kristina Cassandra San Miguel
• Tony San Miguel
• Amarilis San Vicente, DDS
• Janie Sanabria
• Berna Sanayei, DDS
• Nelly Sanchez Arreola
• Sanchez Chiropractic Wellness Center Pain Management

• Speech-Language Assistant in San Jose, CA
• Providers in San Jose, CA by specialty
• Speech-Language Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2023; 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.