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Revervale Psychotherapy PC

Clinic/Center in Milpitas, CA. Organization (NPI-2).

NPI number1962090761
StatusActive
Last updated in NPPESDec 30, 2022

Details

NPI
1962090761
Entity type
Organization (NPI-2)
Legal business name
Revervale Psychotherapy PC
Organization subpart
No
Enumeration date
Jan 6, 2021
Certification date
Dec 30, 2022
Last updated
Dec 30, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261Q00000X Clinic/Center––Yes

Practice location

1636 Watson Ct
Milpitas, CA 95035-6822

Phone 650-714-7595 · Fax 669-235-8105

Mailing address

1636 Watson Ct
Milpitas, CA 95035-6822

Phone 650-714-7595 · Fax 669-235-8105

Authorized official

Vinh Q Thai
President
6507147595

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