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General NPI Number Information
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NPI Number | 1104094770
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Entity Type | Organization
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Legal Business Name | SANTA CLARA COUNTY DRUG & ALCOHOL
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Dates
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Enumeration Date | 02/15/2008
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Last Update Date | 02/15/2008
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Provider Practice Location Address
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Address Line | 2425 ENBORG LANE
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City | SAN JOSE
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State | CA
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Zip | 95128
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Country | US
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Telephone | 408-885-3406
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Fax |
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Provider Business Mailing Address
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Address Line | 2425 ENBORG LANE
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City | SAN JOSE
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State | CA
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Zip | 95128
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Country | US
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Telephone | 408-885-3406
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Fax |
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Authorized Official
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Title or Position | COUNSELOR
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Name | MR. FRANK WILLIAM BARKER
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Credential | CADC II
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Telephone | 408-885-3406
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number |
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number | N4342331
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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License Number State | CA
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