| NPI | 1699219881 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL DANIEL HICKEY Behavioral Health Clinician Ii 408-755-3905 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: CA 46836) |
| Additional Taxonomies | 251B00000X Case Management (Licence: CA 46836) |
| Enumeration Date | 2016-12-07 |
| Last Update Date | 2016-12-07 |