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General NPI Number Information
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NPI Number | 1548903016
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Entity Type | Organization
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Legal Business Name | CROSSROADS PSYCHOLOGICAL ASSESSMENT AND TREATMENT CENTER
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Dates
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Enumeration Date | 04/13/2022
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Last Update Date | 04/14/2022
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Provider Practice Location Address
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Address Line | 3880 S BASCOM AVE STE 217
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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 | 408-637-7827
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Fax |
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Provider Business Mailing Address
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Address Line | 3880 S BASCOM AVE STE 217
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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 |
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Fax |
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Authorized Official
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Title or Position | CEO/PROVIDER
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Name | HOLLY-MARIE ARCE
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Credential | PSYD
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Telephone | 951-764-4968
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service 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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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