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General NPI Number Information
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NPI Number | 1891293734
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Entity Type | Organization
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Legal Business Name | SPIRAL PROCESS THERAPY
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Dates
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Enumeration Date | 01/25/2018
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Last Update Date | 11/24/2020
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Provider Practice Location Address
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Address Line | 815 W SAN FERNANDO ST
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City | SAN JOSE
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State | CA
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Zip | 95126-4815
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Country | US
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Telephone | 718-737-1498
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Fax |
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Provider Business Mailing Address
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Address Line | 815 W SAN FERNANDO ST
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City | SAN JOSE
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State | CA
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Zip | 95126-4815
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Country | US
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Telephone | 718-737-1498
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Fax |
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | NADIA VULFOVICH
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Credential |
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Telephone | 718-737-1498
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 100394
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License Number State | CA
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