MEDICARE: ALUM ROCK 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
1	251S00000X	Community/Behavioral Health Agency		CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326401316
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALUM ROCK COUNSELING CENTER

Provider Business Mailing Address
First Line	:	1245 E SANTA CLARA ST
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95116-2337
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3411 ROCKY MOUNTAIN DR
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95127-4853
Country	:	US
Telephone Number	:	408-240-0070
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	PATRICIA CHIAPELLONE
Credential	:
Telephone Number	:	408-240-0070

Provider Enumeration Date	:	03/29/2016
Last Update Date	:	04/01/2016

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Directions to “ALUM ROCK COUNSELING CENTER ” Practice Location

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