Healthcare Provider Details

I. General information

NPI: 1710256342
Provider Name (Legal Business Name): UJIMA ADULT AND FAMILY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2011
Last Update Date: 12/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1898 THE ALAMEDA
SAN JOSE CA
95126-1733
US

IV. Provider business mailing address

1898 THE ALAMEDA
SAN JOSE CA
95126-1733
US

V. Phone/Fax

Practice location:
  • Phone: 408-928-1700
  • Fax: 408-928-1701
Mailing address:
  • Phone: 408-928-1700
  • Fax: 408-928-1701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MS. YVONNE RENE MAXWELL
Title or Position: EXECUTIVE DIRECTOR
Credential: LCSW
Phone: 408-928-1700