Healthcare Provider Details
I. General information
NPI: 1407528060
Provider Name (Legal Business Name): FRANK VINCENT SERRANO BA, MSW, ED.D., MHRS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 10/01/2021
Last Update Date: 10/01/2021
Certification Date: 06/21/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
751 S BASCOM AVE # 1A068
SAN JOSE CA
95128-2699
US
IV. Provider business mailing address
555 FISHER AVE
MORGAN HILL CA
95037-5511
US
V. Phone/Fax
- Phone: 408-710-9068
- Fax:
- Phone: 408-710-9068
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225400000X |
| Taxonomy | Rehabilitation Practitioner |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225C00000X |
| Taxonomy | Rehabilitation Counselor |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: