Basic Information
| Provider Information | |||||||||
| NPI: | 1134433899 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CALDERWOOD | ||||||||
| FirstName: | SCOTT | ||||||||
| MiddleName: | W | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5084 WOODBRAE CT | ||||||||
| Address2: | |||||||||
| City: | SARATOGA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 950704756 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8779910009 | ||||||||
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| Practice Location | |||||||||
| Address1: | 405 ALBERTO WAY | ||||||||
| Address2: | SUITE D&E | ||||||||
| City: | LOS GATOS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 950325406 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8779910009 | ||||||||
| FaxNumber: | 8779910009 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/04/2010 | ||||||||
| LastUpdateDate: | 08/04/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | RPE6269 | CA | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.