Healthcare Provider Details

I. General information

NPI: 1770382244
Provider Name (Legal Business Name): RESILIENT MINDS COLLECTIVE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2025
Last Update Date: 03/10/2025
Certification Date: 03/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1972 THE ALAMEDA
SAN JOSE CA
95126-1432
US

IV. Provider business mailing address

1972 THE ALAMEDA
SAN JOSE CA
95126-1432
US

V. Phone/Fax

Practice location:
  • Phone: 408-766-2547
  • Fax:
Mailing address:
  • Phone: 408-766-2547
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DARLENE NORMAN
Title or Position: OWNER/CFO
Credential: LEP
Phone: 408-827-1208