| Momentum For Health - Fsp Imd | |
|
86 S 14th St San Jose CA 95112-2015 | |
| (408) 938-8500 | |
| (408) 295-4231 |
| Full Name | Momentum For Health - Fsp Imd |
|---|---|
| Speciality | Psychologist |
| Location | 86 S 14th St, San Jose, California |
| Authorized Official Name and Position | David K. Mineta (CEO) |
| Authorized Official Contact | 6692130755 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Momentum For Health - Fsp Imd 1922 The Alameda San Jose CA 95126-1457 Ph: (408) 642-6053 | Momentum For Health - Fsp Imd 86 S 14th St San Jose CA 95112-2015 Ph: (408) 938-8500 |
| NPI Number | 1285877308 |
|---|---|
| Provider Enumeration Date | 04/20/2009 |
| Last Update Date | 12/28/2022 |
| Certification Date | 12/28/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285877308 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
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