Individual
MISS AMY VIVIAN COOLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
438 N WHITE RD, SAN JOSE, CA 95127-1439
(408) 254-6848
Mailing address
438 N WHITE RD, SAN JOSE, CA 95127-1439
(408) 254-6848
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
104100000X
Social Worker
34174
CA
1041C0700X
Clinical Social Worker
Primary
76107
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1306096656
UNKNOWN
CA
Enumeration date
09/23/2008
Last updated
03/20/2017
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