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General NPI Number Information
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NPI Number | 1659147940
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Entity Type | Organization
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Legal Business Name | GROWING MINDS MENTAL HEALTH SERVICES
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Dates
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Enumeration Date | 11/28/2023
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Last Update Date | 01/07/2025
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Provider Practice Location Address
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Address Line | 120 SANTA MARGARITA AVE BLDG B
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City | MENLO PARK
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State | CA
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Zip | 94025-2725
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Country | US
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Telephone | 650-727-1523
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Fax |
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Provider Business Mailing Address
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Address Line | 530 LYTTON AVE FL 2
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City | PALO ALTO
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State | CA
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Zip | 94301-1541
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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 | PRESIDENT
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Name | DR. YANG N/A XU
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Credential | MD
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Telephone | 650-727-1523
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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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 | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number |
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License Number State |
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