| Momentum Fro Mental Health - Donnas Place | |
|
2001 The Alameda San Jose CA 95126-1136 | |
| (408) 261-7777 | |
| (408) 554-9960 |
| Full Name | Momentum Fro Mental Health - Donnas Place |
|---|---|
| Speciality | Psychologist |
| Location | 2001 The Alameda, San Jose, California |
| Authorized Official Name and Position | John S. Smelser (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 4082617777 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Momentum Fro Mental Health - Donnas Place 2001 The Alameda San Jose CA 95126-1136 Ph: (408) 261-7777 | Momentum Fro Mental Health - Donnas Place 2001 The Alameda San Jose CA 95126-1136 Ph: (408) 261-7777 |
| NPI Number | 1477765105 |
|---|---|
| Provider Enumeration Date | 05/04/2007 |
| Last Update Date | 08/06/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477765105 | NPI | - | NPPES |
| 000008389 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
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