| City Of San Jose Grace Community Center | |
|
484 E San Fernando St San Jose CA 95112-3513 | |
| (408) 293-0422 | |
| Not Available |
| Full Name | City Of San Jose Grace Community Center |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 484 E San Fernando St, San Jose, California |
| Authorized Official Name and Position | Lisa Blevins (DIRECTOR) |
| Authorized Official Contact | 4082930422 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| City Of San Jose Grace Community Center 484 E San Fernando St San Jose CA 95112-3513 Ph: (408) 293-0422 | City Of San Jose Grace Community Center 484 E San Fernando St San Jose CA 95112-3513 Ph: (408) 293-0422 |
| NPI Number | 1134333180 |
|---|---|
| Provider Enumeration Date | 05/09/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134333180 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | PSY 14707 (California) | Primary |
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