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General NPI Number Information
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NPI Number | 1316815038
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Entity Type | Organization
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Legal Business Name | SAN JOSE THERAPY, A LICENSED CLINICAL SOCIAL WORKER CORPORATION
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Dates
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Enumeration Date | 10/24/2025
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Last Update Date | 10/24/2025
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Provider Practice Location Address
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Address Line | 4990 SPEAK LN STE 100
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City | SAN JOSE
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State | CA
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Zip | 95118-2776
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Country | US
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Telephone | 408-418-5560
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Fax | 669-235-4442
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Provider Business Mailing Address
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Address Line | 4990 SPEAK LN STE 100
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City | SAN JOSE
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State | CA
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Zip | 95118-2776
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Country | US
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Telephone | 408-418-5560
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Fax | 669-235-4442
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MR. TROY PAFENBERG
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Credential | LCSW
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Telephone | 408-418-5560
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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 |
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License Number State |
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