Provider Demographics
NPI:1447042007
Name:BACKUS, ZACHARIAH JORDAN (MS)
Entity type:Individual
Prefix:
First Name:ZACHARIAH
Middle Name:JORDAN
Last Name:BACKUS
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1045 POST ST APT 9
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-5625
Mailing Address - Country:US
Mailing Address - Phone:304-972-7332
Mailing Address - Fax:
Practice Address - Street 1:368 JUANA AVE
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94577-4811
Practice Address - Country:US
Practice Address - Phone:357-510-4015
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-20
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist