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General NPI Number Information
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NPI Number | 1114727880
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Entity Type | Individual
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Provider Name | ERIC FORD
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Gender | Male
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Dates
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Enumeration Date | 03/13/2025
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Last Update Date | 03/13/2025
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Provider Practice Location Address
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Address Line | 3880 S BASCOM AVE STE 216
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City | SAN JOSE
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State | CA
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Zip | 95124-2675
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Country | US
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Telephone | 510-963-7367
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Fax |
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Provider Business Mailing Address
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Address Line | 4802 WINGATE DR
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City | PLEASANTON
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State | CA
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Zip | 94566-5525
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Country | US
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Telephone | 510-963-7367
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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