Individual
DERRICK GLASGOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3311 KIFER RD, SANTA CLARA, CA 95051-0708
(510) 453-0812
Mailing address
3311 KIFER RD, SANTA CLARA, CA 95051-0708
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
175T00000X
Peer Specialist
—
—
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
01/26/2023
Last updated
06/25/2025
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