Healthcare Provider Details

I. General information

NPI: 1194650887
Provider Name (Legal Business Name): SHE BLISS TRANSITIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5201 GREAT AMERICAN PKWY SUITE 320
SANTA CLARA CA
95054
US

IV. Provider business mailing address

500 S ALMADEN BLVD #514
SAN JOSE CA
95110
US

V. Phone/Fax

Practice location:
  • Phone: 408-562-6123
  • Fax:
Mailing address:
  • Phone: 725-335-4048
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code3245S0500X
TaxonomyChildren's Substance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: KIMINI RANDALL
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 725-335-4048