Healthcare Provider Details

I. General information

NPI: 1659293009
Provider Name (Legal Business Name): VINCENT RADOFF MS, APCC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

499 LOMA ALTA AVE
LOS GATOS CA
95030-6227
US

IV. Provider business mailing address

1 GOLDENRIDGE CT
SAN MATEO CA
94402-3717
US

V. Phone/Fax

Practice location:
  • Phone: 877-722-2737
  • Fax:
Mailing address:
  • Phone: 907-887-1119
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: