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2101 Alexian Dr Ste 110 San Jose CA 95116-1901 | |
| (408) 272-6518 | |
| (408) 272-6569 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2101 Alexian Dr Ste 110, San Jose, California |
| Authorized Official Name and Position | Sherri Terao (DIR, BEHAVIORAL HEALTH SVCS) |
| Authorized Official Contact | 4088855776 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
828 S Bascom Ave Ste 200 San Jose CA 95128-2600 Ph: (408) 885-5770 | 2101 Alexian Dr Ste 110 San Jose CA 95116-1901 Ph: (408) 272-6518 |
| NPI Number | 1043354855 |
|---|---|
| Provider Enumeration Date | 02/16/2007 |
| Last Update Date | 01/02/2025 |
| Certification Date | 01/02/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043354855 | NPI | - | NPPES |
| 4387 | Other | CA | DRUG MEDI-CAL NUMBER |
| 434387 | Other | CA | STATE PROVIDER NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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