=====================================================
General NPI Number Information
=====================================================
NPI Number | 1932997699
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | VIRTUE THERAPY LICENSED CLINICAL SOCIAL WORKER, PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/30/2025
-----------------------------------------------------
Last Update Date | 10/09/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 151 CLEAVES AVE
-----------------------------------------------------
City | SAN JOSE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95126-3002
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 408-784-8654
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 151 CLEAVES AVE
-----------------------------------------------------
City | SAN JOSE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95126-3002
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 408-784-8654
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO/ MENTAL HEALTH THERAPIST
-----------------------------------------------------
Name | ESTEFANIA RAMIREZ-ROMO
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 408-784-8654
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM0801X
-----------------------------------------------------
Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------