MEDICARE: DONALD FELICE BA

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	101YP2500X	Professional Counselor
2	101YM0800X	Mental Health Counselor
3	171M00000X	Case Manager/Care Coordinator	CA
4	225C00000X	Rehabilitation Counselor
5	225400000X	Rehabilitation Practitioner	CA

General Provider Information

NPI Number	:	1922129113
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONALD FELICE BA

Provider Business Mailing Address
First Line	:	3031 TISCH WAY STE 306
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95128-2530
Country	:	US
Telephone Number	:	831-235-1402
Fax Number	:	831-535-5449

Provider Business Practice Location Address
First Line	:	3031 TISCH WAY STE 306
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95128-2530
Country	:	US
Telephone Number	:	831-235-1402
Fax Number	:	831-535-5449

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/03/2007
Last Update Date	:	06/11/2025

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