Organization
BILL WILSON CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL ROUSE MFT (DIRECTOR - TAY MENTAL HEALTH & SLS)
(408) 278-2531
Entity
Organization
Contact information
Practice address
1635 PARK AVE, SAN JOSE, CA 95126-2123
(408) 278-2531
Mailing address
PO BOX 127, NAPA, CA 94559-0127
(707) 255-3300
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
106H00000X
Marriage & Family Therapist
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
01/22/2016
Last updated
03/15/2022
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