Healthcare Provider Details

I. General information

NPI: 1821369216
Provider Name (Legal Business Name): ASPIRA WELLNESS AND EDUCATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2012
Last Update Date: 08/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

588 BLOSSOM HILL RD STE A
SAN JOSE CA
95123-3211
US

IV. Provider business mailing address

588 BLOSSOM HILL RD STE A
SAN JOSE CA
95123-3211
US

V. Phone/Fax

Practice location:
  • Phone: 408-309-2947
  • Fax:
Mailing address:
  • Phone: 408-309-2947
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: VERNON BROWN I
Title or Position: CEO
Credential:
Phone: 650-866-4080