Healthcare Provider Details

I. General information

NPI: 1942355730
Provider Name (Legal Business Name): CLARENCE EDWARD BATTS JR. B.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 07/05/2025
Certification Date: 07/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

438 N WHITE RD
SAN JOSE CA
95127-1439
US

IV. Provider business mailing address

400 EDMONDS RD
REDWOOD CITY CA
94062-3803
US

V. Phone/Fax

Practice location:
  • Phone: 408-254-6848
  • Fax: 408-642-6052
Mailing address:
  • Phone: 650-839-1810
  • Fax: 650-839-1463

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: