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NPI Code Detail

MEDICARE: ALLIANCE COMMUNITY COUNSELING CENTER

MEDICARE: ALLIANCE COMMUNITY COUNSELING CENTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselorMFT & LCSW IN GROUPCA

General Provider Information

NPI Number : 1013087816
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALLIANCE COMMUNITY COUNSELING CENTER
Provider Business Mailing Address
First Line : 1040 LINCOLN AVE
Second Line :
City : SAN JOSE
State : CA
Zip : 95125-3150
Country : US
Telephone Number : 408-293-4489
Fax Number : 408-293-6188
Provider Business Practice Location Address
First Line : 1040 LINCOLN AVE
Second Line :
City : SAN JOSE
State : CA
Zip : 95125-3150
Country : US
Telephone Number : 408-293-4489
Fax Number : 408-293-6188
Authorized Official
Title or Position : DIRECTOR
Name : DR. JAN KEARNY
Credential : PH.D.
Telephone Number : 408-293-4489
Provider Enumeration Date : 11/09/2006
Last Update Date : 08/22/2020

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Directions to “ALLIANCE COMMUNITY COUNSELING CENTER ” Practice Location

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