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General NPI Number Information
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NPI Number | 1740413624
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Entity Type | Organization
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Legal Business Name | CATHOLIC CHARITIES OF SANTA CLARA COUNTY
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Dates
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Enumeration Date | 08/26/2009
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Last Update Date | 08/26/2009
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Provider Practice Location Address
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Address Line | 2625 ZANKER RD
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City | SAN JOSE
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State | CA
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Zip | 95134-2130
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Country | US
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Telephone | 408-955-9170
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Fax | 408-944-9114
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Provider Business Mailing Address
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Address Line | 2625 ZANKER RD
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City | SAN JOSE
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State | CA
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Zip | 95134-2130
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Country | US
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Telephone | 408-955-9170
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Fax | 408-944-9114
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Authorized Official
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Title or Position | CLINICAL DIRECTOR OF BEHAV. HEALTH
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Name | RON OBER
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Credential | LCSW
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Telephone | 408-325-5183
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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License Number State |
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