Healthcare Provider Details

I. General information

NPI: 1730968868
Provider Name (Legal Business Name): ALUM ROCK COUNSELING CENTER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2023
Last Update Date: 08/09/2024
Certification Date: 08/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 E SANTA CLARA ST STE 105
SAN JOSE CA
95112-1936
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 408-885-5770
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: VERONICA MELGOZA GAMBOA
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 408-771-1734