Organization
CITY OF SAN JOSE GRACE COMMUNITY CENTER WOMEN'S PROGRAM
Active
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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