Organization
CITY OF SAN JOSE GRACE COMMUNITY CENTER WOMEN'S PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA BLEVINS PH.D. (DIRECTOR)
(408) 293-0422
Entity
Organization
Contact information
Practice address
146 S 10TH ST, SAN JOSE, CA 95112-3641
(408) 293-0422
(408) 277-2474
Mailing address
484 E SAN FERNANDO ST, SAN JOSE, CA 95112-3513
(408) 293-0422
(408) 277-2474
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
PSY14707
CA
Other
Enumeration date
05/11/2007
Last updated
08/22/2020
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