Organization
COUNTY OF SANTA CLARA
Active
Parent organization
COUNTY OF SANTA CLARA
Other names
SCCMHD - KidScope
Organization subpart
Yes
Provider details
NPI number
Legal business name
COUNTY OF SANTA CLARA
Authorized official
DR. NANCY DANE PENA PH.D. (DIRECTOR)
(408) 885-5782
Entity
Organization
Contact information
Practice address
828 S BASCOM AVE, SUITE 100 AND 120, SAN JOSE, CA 95128-2651
(408) 793-5959
Mailing address
828 S BASCOM AVE, SUITE 200, SAN JOSE, CA 95128-2651
(408) 885-5770
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
43AP
SDMH PROVIDER NUMBER
CA
Enumeration date
03/21/2007
Last updated
02/13/2012
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