| Sondermind Pc | |
|
6203 San Ignacio Ave Ste 110 San Jose CA 95119-1358 | |
| (844) 843-7279 | |
| Not Available |
| Full Name | Sondermind Pc |
|---|---|
| Speciality | Social Worker |
| Location | 6203 San Ignacio Ave Ste 110, San Jose, California |
| Authorized Official Name and Position | Tanya Roach (CHIEF ADMINISTRATIVE CRED OFFICER) |
| Authorized Official Contact | 8448437279 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sondermind Pc 6203 San Ignacio Ave Ste 110 San Jose CA 95119-1358 Ph: (844) 843-7279 | Sondermind Pc 6203 San Ignacio Ave Ste 110 San Jose CA 95119-1358 Ph: (844) 843-7279 |
| NPI Number | 1003646977 |
|---|---|
| Provider Enumeration Date | 08/06/2024 |
| Last Update Date | 11/22/2024 |
| Certification Date | 11/22/2024 |
| Medicare PECOS PAC ID | 0547795791 |
|---|---|
| Medicare Enrollment ID | O20241125001063 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003646977 | NPI | - | NPPES |
| Provider Name | Johnny White |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306149497 PECOS PAC ID: 9830186360 Enrollment ID: I20040427001556 |
| Provider Name | Jamila Watson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326540204 PECOS PAC ID: 1951645050 Enrollment ID: I20181130000210 |
| Provider Name | Jalinia Logan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316587520 PECOS PAC ID: 7416378708 Enrollment ID: I20200521001513 |
| Provider Name | Jennifer L Brau |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134591092 PECOS PAC ID: 8729377379 Enrollment ID: I20211208001333 |
| Provider Name | Kristi Ann Weaver |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1053669903 PECOS PAC ID: 4688016025 Enrollment ID: I20240530001751 |
| Provider Name | Joy Watkins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063713535 PECOS PAC ID: 6305200486 Enrollment ID: I20240912002720 |
| Provider Name | Terri Larae Griswold |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1740667104 PECOS PAC ID: 8820532633 Enrollment ID: I20240925001474 |
| Provider Name | Amanda Jo Gonzalez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225567480 PECOS PAC ID: 1254702178 Enrollment ID: I20241014003800 |
| Provider Name | April Viverette |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841744190 PECOS PAC ID: 3173853181 Enrollment ID: I20241218000385 |
| Provider Name | Shari Tucker |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1619783065 PECOS PAC ID: 3274062872 Enrollment ID: I20250128001784 |
| Provider Name | Keshia Knight |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871192534 PECOS PAC ID: 2163842410 Enrollment ID: I20250228002342 |
| Provider Name | Phillip Alan Davis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891370201 PECOS PAC ID: 4981125333 Enrollment ID: I20250303000843 |
| Provider Name | Morgan Deamezola |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1558985135 PECOS PAC ID: 1850731324 Enrollment ID: I20250306001132 |
| Provider Name | Mary Oneafolu |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1588061873 PECOS PAC ID: 5294256269 Enrollment ID: I20250306001164 |
| Provider Name | Yi-ling Linda Kuo-rice |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1760555031 PECOS PAC ID: 1456872431 Enrollment ID: I20250306001275 |
| Provider Name | Jermaine Anthony |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811435027 PECOS PAC ID: 6901327832 Enrollment ID: I20250309000057 |
| Provider Name | Samantha Christina Scott Troutt |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1568790913 PECOS PAC ID: 0345761417 Enrollment ID: I20250310003222 |
| Provider Name | Svetlana Burak |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1306694336 PECOS PAC ID: 8426579921 Enrollment ID: I20250312001558 |
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