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Organization
MOMENTUM FOR MENTAL HEALTH- ISP & FSP
Active
Organization
MOMENTUM FOR MENTAL HEALTH- ISP & FSP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN S SMELSER (CFO)
(408) 261-7777
Entity
Organization
Contact information
Practice address
150 S AUTUMN ST STE A, SAN JOSE, CA 95110-2515
(408) 938-6750
(408) 977-0145
Mailing address
2001 THE ALAMEDA, SAN JOSE, CA 95126-1136
(408) 261-7777
(408) 554-9960
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000043AR
—
CA
Enumeration date
04/19/2007
Last updated
08/01/2008
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