Healthcare Provider Details

I. General information

NPI: 1528337300
Provider Name (Legal Business Name): ALUM ROCK COUNSELING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2011
Last Update Date: 12/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

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

IV. Provider business mailing address

1476 KENTFIELD AVE
REDWOOD CITY CA
94061-2702
US

V. Phone/Fax

Practice location:
  • Phone: 408-294-0500
  • Fax:
Mailing address:
  • Phone: 805-252-6009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MISS PATRICIA CHIAPELLONE
Title or Position: CEO
Credential:
Phone: 408-240-0070