Prentice Powell
Community/Behavioral Health in San Jose, CA. Individual provider (NPI-1).
NPI number1760880462
StatusActive
Last updated in NPPESDec 11, 2014
Details
- NPI
- 1760880462
- Entity type
- Individual (NPI-1)
- Name
- Prentice Powell
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Dec 11, 2014
- Last updated
- Dec 11, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 251S00000X | Community/Behavioral Health | – | – | Yes |
Practice location
2177 Alum Rock Ave Apt 139San Jose, CA 95116-2063
Phone 510-383-6335
Mailing address
2177 Alum Rock Ave Apt 139San Jose, CA 95116-2063
Phone 510-383-6335
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