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General NPI Number Information
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NPI Number | 1386126621
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Entity Type | Organization
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Legal Business Name | ALUM ROCK COUNSELING CENTER
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Dates
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Enumeration Date | 09/04/2018
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Last Update Date | 09/04/2018
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Provider Practice Location Address
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Address Line | 14281 STORY ROAD
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City | SAN JOSE
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State | CA
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Zip | 95127
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Country | US
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Telephone | 408-240-0070
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Fax |
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Provider Business Mailing Address
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Address Line | 1245 E SANTA CLARA ST
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City | SAN JOSE
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State | CA
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Zip | 95116-2337
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | QA MANAGER
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Name | MAXIMILIAN MASAHITO KUBOTA
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Credential | LMFT
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Telephone | 408-394-1761
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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