MEDICARE: MOMENTUM FOR HEALTH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154426807
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOMENTUM FOR HEALTH

Provider Business Mailing Address
First Line	:	1922 THE ALAMEDA STE 316
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95126-1461
Country	:	US
Telephone Number	:	408-261-7777
Fax Number	:	408-642-6052

Provider Business Practice Location Address
First Line	:	2001 THE ALAMEDA
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95126-1136
Country	:	US
Telephone Number	:	408-261-7777
Fax Number	:	408-642-6052

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	MICHAEL SCATES
Credential	:
Telephone Number	:	408-261-7777

Provider Enumeration Date	:	09/14/2006
Last Update Date	:	09/04/2025

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Directions to “MOMENTUM FOR HEALTH ” Practice Location

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