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General NPI Number Information
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NPI Number | 1750204558
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Entity Type | Organization
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Legal Business Name | THE MIRI CENTER, A PROFESSIONAL PSYCHOLOGICAL CORPORATION
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Dates
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Enumeration Date | 07/30/2026
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Last Update Date | 07/30/2026
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Provider Practice Location Address
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Address Line | 855 LENZEN AVE
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City | SAN JOSE
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State | CA
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Zip | 95126-2736
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Country | US
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Telephone | 408-247-4123
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Fax |
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Provider Business Mailing Address
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Address Line | 6081 MERIDIAN AVE STE 70-298
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City | SAN JOSE
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State | CA
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Zip | 95120-2752
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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 | DIRECTOR
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Name | JENNIFER HOLMBERG
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Credential | LCSW
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Telephone | 310-600-8277
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number |
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License Number State |
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