Healthcare Provider Details

I. General information

NPI: 1780132043
Provider Name (Legal Business Name): COUNTY OF SANTA CLARA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2016
Last Update Date: 08/01/2023
Certification Date: 08/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 W TASMAN DR
SAN JOSE CA
95134-1700
US

IV. Provider business mailing address

828 S BASCOM AVE STE 200
SAN JOSE CA
95128-2600
US

V. Phone/Fax

Practice location:
  • Phone: 408-793-0550
  • Fax:
Mailing address:
  • Phone: 408-885-5770
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: SHERRI TERAO
Title or Position: DIRECTOR, BEHAVIORAL HEALTH SVC
Credential:
Phone: 408-885-5776