| Santa Clara County Dads | |
|
976 Lenzen Ave First Floor San Jose CA 95126-2737 | |
| (408) 792-5247 | |
| (408) 947-8719 |
| Full Name | Santa Clara County Dads |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 976 Lenzen Ave, San Jose, California |
| Authorized Official Name and Position | Laurie Ann Smith (PSYCHIATRIC SOCIAL WORKER 1) |
| Authorized Official Contact | 4087925247 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Santa Clara County Dads 976 Lenzen Ave First Floor San Jose CA 95126-2737 Ph: (408) 792-5247 | Santa Clara County Dads 976 Lenzen Ave First Floor San Jose CA 95126-2737 Ph: (408) 792-5247 |
| NPI Number | 1225166317 |
|---|---|
| Provider Enumeration Date | 03/01/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225166317 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | ASW 13459 (California) | Primary |
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