Healthcare Provider Details

I. General information

NPI: 1053453589
Provider Name (Legal Business Name): KEVIN MICHAEL GELARDI BA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/12/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ALLIANCE FOR COMMUNITY CARE INTENSIVE SERVICES PROGRAM 86 S 14TH ST
SAN JOSE CA
95112-2015
US

IV. Provider business mailing address

ALLIANCE FOR COMMUNITY CARE 2001 THE ALAMEDA
SAN JOSE CA
95126-1136
US

V. Phone/Fax

Practice location:
  • Phone: 408-938-6750
  • Fax: 408-977-0145
Mailing address:
  • Phone: 408-261-7777
  • Fax: 408-254-9960

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: