Healthcare Provider Details

I. General information

NPI: 1962653493
Provider Name (Legal Business Name): MR. FRANCIS JEROME FIHN JR.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: MR. JERRY FIHN

II. Dates (important events)

Enumeration Date: 10/02/2008
Last Update Date: 09/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3880 S BASCOM AVE SUITE 202
SAN JOSE CA
95124-2674
US

IV. Provider business mailing address

3880 S BASCOM AVE SUITE 202
SAN JOSE CA
95124-2674
US

V. Phone/Fax

Practice location:
  • Phone: 408-566-3683
  • Fax:
Mailing address:
  • Phone: 408-566-3683
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number53136
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: