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Organization
STATE OF CALIFORNIA - DEPARTMENT OF DEVELOPMENTAL SERVICES
Active
Organization
STATE OF CALIFORNIA - DEPARTMENT OF DEVELOPMENTAL SERVICES
Active
Other names
Agnews Developmental Center
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KATHY KINSER (DEPUTY DIRECTOR)
(916) 654-1963
Entity
Organization
Contact information
Practice address
3500 ZANKER RD, SAN JOSE, CA 95134-2201
(408) 451-6198
(408) 451-6167
Mailing address
PO BOX 944202, 1600 9TH STREET, SACRAMENTO, CA 94244-2020
(916) 654-2431
(916) 654-3186
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
160000519
CA
313M00000X
Nursing Facility/Intermediate Care Facility
160000519
CA
314000000X
Skilled Nursing Facility
160000519
CA
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
160000519
CA
333600000X
Pharmacy
160000519
CA
Other
Enumeration date
05/12/2006
Last updated
01/06/2009
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