MEDICARE: SAN JOSE CONSERVATION CORPS

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
1	101YS0200X	School Counselor

General Provider Information

NPI Number	:	1023976511
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAN JOSE CONSERVATION CORPS

Provider Business Mailing Address
First Line	:	1560 BERGER DR
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95112-2703
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2650 SENTER RD
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95111-1121
Country	:	US
Telephone Number	:	408-283-7171
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT OF EDUCATION
Name	:	ANDREA MAES
Credential	:
Telephone Number	:	408-595-3503

Provider Enumeration Date	:	01/13/2026
Last Update Date	:	01/13/2026

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Directions to “SAN JOSE CONSERVATION CORPS ” Practice Location

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