# DADS-EVTR

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1477679561
- **Authorized official:** BENJAMIN PAREDES (REHABILITATION COUNSELOR)
- **Authorized official phone:** (408) 272-6581

## Contact information

- **Practice address:** 2101 ALEXIAN DR STE B, SAN JOSE, CA 95116-1901
- **Practice address phone:** (408) 272-6524
- **Practice address fax:** (408) 272-6590
- **Mailing address:** 2101 ALEXIAN DR STE B, SAN JOSE, CA 95116-1901
- **Mailing address phone:** (408) 272-6524
- **Mailing address fax:** (408) 272-6590

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302R00000X | Health Maintenance Organization | 101YA0400X | CA | Yes |

## Other

- **Enumeration date:** 03/21/2007
- **Last updated:** 08/22/2020