NPI 1003368994

Path

Organisation Case Management Agency San Jose, CA

Practice location

Address: 290 N 2nd Street, San Jose, CA 95112-1231
Phone: (408) 320-9035
Mailing address: 290 N 2nd Street, San Jose, CA 95112

Authorised official

Name: La Keishia Nicole Childers
Title: Sr. Director of Compliance & Qa
Phone: (323) 644-2224

Registered specialties

Case Management Agency Primary

Agencies Taxonomy 251B00000X Licence 1003223124 (CA)

Other Case Management providers in California →

Registry record

NPI: 1003368994
Entity type: Organization
NPI issued: 26 Oct 2016
Record last updated: 19 Nov 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.