| Starlight Adolescent Center | |
|
455 Silicon Valley Blvd San Jose CA 95138-1858 | |
| (408) 284-9000 | |
| (408) 284-9048 |
| Full Name | Starlight Adolescent Center |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 455 Silicon Valley Blvd, San Jose, California |
| Authorized Official Name and Position | Mary Jane Gross (PRESIDENT) |
| Authorized Official Contact | 5106359705 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Starlight Adolescent Center 455 Silicon Valley Blvd San Jose CA 95138-1858 Ph: (408) 284-9000 | Starlight Adolescent Center 455 Silicon Valley Blvd San Jose CA 95138-1858 Ph: (408) 284-9000 |
| NPI Number | 1306938402 |
|---|---|
| Provider Enumeration Date | 09/28/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306938402 | NPI | - | NPPES |
| 43AG | Other | CA | SANTA CLARA CTY. MED PROV |
| 2215524 | Other | CA | STATE CORP # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (California) | Primary |
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