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General NPI Number Information
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NPI Number | 1396792875
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Entity Type | Organization
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Legal Business Name | SAN JOSE CITY COLLEGE STUDENT HEALTH SERVICES
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Dates
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Enumeration Date | 05/28/2006
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Last Update Date | 11/06/2015
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Provider Practice Location Address
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Address Line | 2100 MOORPARK AVE SC109
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City | SAN JOSE
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State | CA
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Zip | 95128-2723
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Country | US
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Telephone | 408-288-3724
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Fax | 408-297-4865
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Provider Business Mailing Address
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Address Line | 2100 MOORPARK AVE SC109
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City | SAN JOSE
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State | CA
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Zip | 95128-2723
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Country | US
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Telephone | 408-288-3724
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Fax | 408-297-4865
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Authorized Official
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Title or Position | DIRECTOR OF HEALTH SERVICES
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Name | JANET CHANG
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Credential | RN
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Telephone | 408-288-3821
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1000X
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Taxonomy Name | Student Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QS1000X
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Taxonomy Name | Student Health Clinic/Center
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License Number |
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License Number State | CA
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