Healthcare Provider Details
I. General information
NPI: 1821877226
Provider Name (Legal Business Name): ALUM ROCK COUNSELING CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/25/2023
Last Update Date: 09/25/2023
Certification Date: 09/25/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2741 MIDDLEFIELD RD STE 102
PALO ALTO CA
94306-2567
US
IV. Provider business mailing address
1245 E SANTA CLARA ST
SAN JOSE CA
95116-2337
US
V. Phone/Fax
- Phone: 650-798-6330
- Fax:
- Phone: 408-294-0070
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
VERONICA
MELGOZA
GAMBOA
Title or Position: CHIEF OPERATING OFFICER
Credential: LMFT
Phone: 408-771-1734