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Organization

MH CLINIC AT JUVENILE HALL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DONNA COHEN-CRETCHER (INTERN COORDINATOR)
(408) 792-3910
Entity
Organization

Contact information

Practice address
840 GUADALUPE PKWY, SAN JOSE, CA 95110-1714
(408) 299-3166
Mailing address
210 S 1ST ST UNIT 412, SAN JOSE, CA 95113-2724
(559) 347-8001

Taxonomy

Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary

Other

Enumeration date
08/16/2011
Last updated
08/16/2011
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