Healthcare Provider Details

I. General information

NPI: 1194674002
Provider Name (Legal Business Name): NEW HOPE FOR YOUTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2026
Last Update Date: 01/23/2026
Certification Date: 01/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 GREAT OAKS BLVD STE 265
SAN JOSE CA
95119-1459
US

IV. Provider business mailing address

117 BERNAL RD # 70-311
SAN JOSE CA
95119-1375
US

V. Phone/Fax

Practice location:
  • Phone: 408-854-9166
  • Fax:
Mailing address:
  • Phone: 408-854-9166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: PHILLIP RODRIGUEZ
Title or Position: CEO
Credential:
Phone: 408-854-9166