Healthcare Provider Details

I. General information

NPI: 1578385993
Provider Name (Legal Business Name): PERFECTO BINAS QUIACHON III
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/28/2024
Last Update Date: 09/30/2025
Certification Date: 09/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

631 RIVER OAKS PKWY
SAN JOSE CA
95134-1907
US

IV. Provider business mailing address

3771 SAN PABLO CT
SAN JOSE CA
95127-1200
US

V. Phone/Fax

Practice location:
  • Phone: 408-416-6543
  • Fax:
Mailing address:
  • Phone: 408-416-6543
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License NumberBACB1247289
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberBACB1247289
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: