MEDICARE: A CENTER FOR HOPE

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	101YM0800X	Mental Health Counselor	MFC 36367	CA

General Provider Information

NPI Number	:	1932342862
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A CENTER FOR HOPE

Provider Business Mailing Address
First Line	:	690 W FREMONT AVE STE 6
Second Line	:
City	:	SUNNYVALE
State	:	CA
Zip	:	94087-4202
Country	:	US
Telephone Number	:	408-431-6317
Fax Number	:	408-738-6607

Provider Business Practice Location Address
First Line	:	690 W FREMONT AVE STE 6
Second Line	:
City	:	SUNNYVALE
State	:	CA
Zip	:	94087-4202
Country	:	US
Telephone Number	:	408-431-6317
Fax Number	:	408-738-6607

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MICHAEL O'HARA KELLEY
Credential	:	PH.D.
Telephone Number	:	408-431-6317

Provider Enumeration Date	:	04/07/2009
Last Update Date	:	04/07/2009

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Directions to “A CENTER FOR HOPE ” Practice Location

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