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General NPI Number Information
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NPI Number | 1871855916
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Entity Type | Organization
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Legal Business Name | ACT FOR MENTAL HEALTH
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Dates
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Enumeration Date | 06/14/2012
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Last Update Date | 10/04/2023
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Provider Practice Location Address
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Address Line | 441 PARK AVENUE
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City | SAN JOSE
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State | CA
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Zip | 95110
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Country | US
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Telephone | 408-287-2640
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. BOX 41132
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City | SAN JOSE
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State | CA
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Zip | 95160-1132
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Country | US
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Telephone | 408-267-2840
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Fax | 408-287-7428
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. ANNA NGUYEN
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Credential | PSYD.
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Telephone | 669-262-7070
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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