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General NPI Number Information
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NPI Number | 1962122937
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Entity Type | Organization
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Legal Business Name | VIDEO GAME CHILD AND FAMILY COUNSELING INC.
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Dates
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Enumeration Date | 08/30/2022
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Last Update Date | 09/24/2025
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Provider Practice Location Address
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Address Line | 1650 ZANKER RD STE 135
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City | SAN JOSE
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State | CA
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Zip | 95112-1128
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Country | US
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Telephone | 408-357-3201
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Fax |
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Provider Business Mailing Address
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Address Line | 2010 EL CAMINO REAL STE 1267
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City | SANTA CLARA
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State | CA
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Zip | 95050-4051
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Country | US
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Telephone | 408-357-2590
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MONET GOLDMAN
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Credential |
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Telephone | 408-357-2590
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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 |
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License Number State |
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