Healthcare Provider Details

I. General information

NPI: 1154979672
Provider Name (Legal Business Name): CATHOLIC CHARITIES OF SANTA CLARA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2019
Last Update Date: 08/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5111 SAN FELIPE RD
SAN JOSE CA
95135-1220
US

IV. Provider business mailing address

2625 ZANKER RD
SAN JOSE CA
95134-2130
US

V. Phone/Fax

Practice location:
  • Phone: 408-270-4900
  • Fax: 408-516-9505
Mailing address:
  • Phone: 408-831-0440
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. LOUISE ARYAPOUR
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 408-325-5115