Healthcare Provider Details

I. General information

NPI: 1992906820
Provider Name (Legal Business Name): JAMES J JURADO LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/29/2007
Last Update Date: 01/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2625 ZANKER RD
SAN JOSE CA
95134-2130
US

IV. Provider business mailing address

2625 ZANKER RD
SAN JOSE CA
95134-2130
US

V. Phone/Fax

Practice location:
  • Phone: 831-247-5870
  • Fax: 831-335-8395
Mailing address:
  • Phone: 831-247-5870
  • Fax: 831-335-8395

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCS14807
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: