Organization
DADS-EVTR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BENJAMIN PAREDES (REHABILITATION COUNSELOR)
(408) 272-6581
Entity
Organization
Contact information
Practice address
2101 ALEXIAN DR STE B, SAN JOSE, CA 95116-1901
(408) 272-6524
(408) 272-6590
Mailing address
2101 ALEXIAN DR STE B, SAN JOSE, CA 95116-1901
(408) 272-6524
(408) 272-6590
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
101YA0400X
CA
Other
Enumeration date
03/21/2007
Last updated
08/22/2020
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