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General NPI Number Information
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NPI Number | 1164657201
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Entity Type | Individual
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Provider Name | CELINDA E. MIRANDA LCSW, PPSC
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Gender | Female
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Dates
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Enumeration Date | 05/19/2009
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Last Update Date | 02/26/2013
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Provider Practice Location Address
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Address Line | 2771 ALUM ROCK AVE
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City | SAN JOSE
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State | CA
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Zip | 95127-2803
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Country | US
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Telephone | 408-945-9978
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Fax | 408-945-9978
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Provider Business Mailing Address
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Address Line | PO BOX 360966
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City | MILPITAS
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State | CA
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Zip | 95036-0966
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Country | US
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Telephone | 408-945-9978
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Fax | 408-945-9978
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCS17106
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License Number State | CA
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