| Agere Trauma Work Psc | |
|
2033 Gateway Pl Unit 664 San Jose CA 95110-3709 | |
| (408) 758-0805 | |
| Not Available |
| Full Name | Agere Trauma Work Psc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 2033 Gateway Pl Unit 664, San Jose, California |
| Authorized Official Name and Position | Diane Ngoc Nguyen (OWNER/CEO) |
| Authorized Official Contact | 4087580805 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Agere Trauma Work Psc 3203 Everdale Dr San Jose CA 95148-3406 Ph: (408) 758-0805 | Agere Trauma Work Psc 2033 Gateway Pl Unit 664 San Jose CA 95110-3709 Ph: (408) 758-0805 |
| NPI Number | 1740022235 |
|---|---|
| Provider Enumeration Date | 06/07/2024 |
| Last Update Date | 06/07/2024 |
| Certification Date | 06/07/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740022235 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
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