Agere Trauma Work Psc
Marriage & Family Therapist in San Jose, CA. Organization (NPI-2).
NPI number1740022235
StatusActive
Last updated in NPPESJun 7, 2024
Details
- NPI
- 1740022235
- Entity type
- Organization (NPI-2)
- Legal business name
- Agere Trauma Work Psc
- Organization subpart
- No
- Enumeration date
- Jun 7, 2024
- Certification date
- Jun 7, 2024
- Last updated
- Jun 7, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | – | – | Yes |
Practice location
2033 Gateway Pl Unit 664San Jose, CA 95110-3709
Phone 408-758-0805
Mailing address
3203 Everdale DrSan Jose, CA 95148-3406
Phone 408-758-0805
Authorized official
Diane Ngoc Nguyen
Owner/Ceo
4087580805
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