Organization
AGERE TRAUMA WORK PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE NGOC NGUYEN LMFT (OWNER/CEO)
(408) 758-0805
Entity
Organization
Contact information
Practice address
2033 GATEWAY PL UNIT 664, SAN JOSE, CA 95110-3709
(408) 758-0805
Mailing address
3203 EVERDALE DR, SAN JOSE, CA 95148-3406
(408) 758-0805
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
06/07/2024
Last updated
06/07/2024
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