Gardner Family Health Network
Clinic/Center, Mental Health (Including Community Mental Health Center) in San Jose, CA. Organization (NPI-2).
NPI number1689239014
StatusActive
Last updated in NPPESMay 1, 2019
Details
- NPI
- 1689239014
- Entity type
- Organization (NPI-2)
- Legal business name
- Gardner Family Health Network
- Organization subpart
- No
- Enumeration date
- May 1, 2019
- Last updated
- May 1, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM0801X | Clinic/Center, Mental Health (Including Community Mental Health Center) | – | – | Yes |
Other names
- Gardner Specialty Mental Health Services (Other Name)
Practice location
160 E Virginia St Ste 100San Jose, CA 95112-5865
Phone 408-579-6178 · Fax 408-579-6143
Mailing address
160 E Virginia St Ste 100San Jose, CA 95112-5865
Phone 408-579-6178 · Fax 408-579-6143
Authorized official
Christina Cornell
Credentialing Supervisor
4085796178
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