| Momentum For Health - La Selva Residential | |
|
652 Forest Ave Palo Alto CA 94301-2622 | |
| (650) 323-1401 | |
| (408) 642-6052 |
| Full Name | Momentum For Health - La Selva Residential |
|---|---|
| Speciality | Psychologist |
| Location | 652 Forest Ave, Palo Alto, 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 - La Selva Residential 1922 The Alameda Ste 316 San Jose CA 95126-1461 Ph: (408) 261-7777 | Momentum For Health - La Selva Residential 652 Forest Ave Palo Alto CA 94301-2622 Ph: (650) 323-1401 |
| NPI Number | 1881813350 |
|---|---|
| Provider Enumeration Date | 04/24/2007 |
| Last Update Date | 02/18/2023 |
| Certification Date | 02/18/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881813350 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
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