Organization
WELLBOUND OF SAN JOSE, LLC
Active
Parent organization
WELLBOUND, LLC
Other names
WellBound of San Mateo
Organization subpart
Yes
Provider details
NPI number
Legal business name
WELLBOUND, LLC
Authorized official
BERNADETTE VINCENT (PRESIDENT/COO)
(650) 404-3600
Entity
Organization
Contact information
Practice address
2000 S EL CAMINO REAL, SAN MATEO, CA 94403-1805
(650) 377-0882
(650) 358-3906
Mailing address
300 SANTANA ROW, SUITE 300, SAN JOSE, CA 95128-2018
(650) 377-0882
(650) 404-3601
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CDC52582F
—
CA
Enumeration date
01/18/2007
Last updated
01/14/2023
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