Healthcare Provider Details

I. General information

NPI: 1376902114
Provider Name (Legal Business Name): ALUM ROCK COUNSELING CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2016
Last Update Date: 07/26/2024
Certification Date: 07/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 OCALA AVE
SAN JOSE CA
95148-1114
US

IV. Provider business mailing address

1245 E SANTA CLARA ST
SAN JOSE CA
95116-2337
US

V. Phone/Fax

Practice location:
  • Phone: 408-240-0070
  • Fax:
Mailing address:
  • Phone: 408-240-0070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateCA

VIII. Authorized Official

Name: VERONICA MELGOZA GAMBOA
Title or Position: COO
Credential: LMFT
Phone: 408-771-1734