| Purpose Driven Adult Services, Inc | |
|
4010 Moorpark Ave Ste 118 San Jose CA 95117-1804 | |
| (510) 474-9952 | |
| (510) 217-4243 |
| Full Name | Purpose Driven Adult Services, Inc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 4010 Moorpark Ave Ste 118, San Jose, California |
| Authorized Official Name and Position | Ayana Lee Paxton (PRESIDENT) |
| Authorized Official Contact | 5104749952 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Purpose Driven Adult Services, Inc 4010 Moorpark Ave Ste 118 San Jose CA 95117-1804 Ph: (510) 474-9952 | Purpose Driven Adult Services, Inc 4010 Moorpark Ave Ste 118 San Jose CA 95117-1804 Ph: (510) 474-9952 |
| NPI Number | 1417661695 |
|---|---|
| Provider Enumeration Date | 01/11/2023 |
| Last Update Date | 01/11/2023 |
| Certification Date | 01/05/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417661695 | NPI | - | NPPES |
| 1891268538 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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