| Sud Specialty Group - Ca | |
|
4633 Old Ironsides Dr Ste 304 Santa Clara CA 95054-1846 | |
| (323) 205-7088 | |
| Not Available |
| Full Name | Sud Specialty Group - Ca |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 4633 Old Ironsides Dr Ste 304, Santa Clara, California |
| Authorized Official Name and Position | Gabriel Diop (AUTHORIZED AGENT) |
| Authorized Official Contact | 3232057088 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sud Specialty Group - Ca Po Box 746877 Atlanta GA 30374-6877 Ph: (323) 205-7088 | Sud Specialty Group - Ca 4633 Old Ironsides Dr Ste 304 Santa Clara CA 95054-1846 Ph: (323) 205-7088 |
| NPI Number | 1972138238 |
|---|---|
| Provider Enumeration Date | 03/06/2020 |
| Last Update Date | 01/09/2025 |
| Certification Date | 01/09/2025 |
| Medicare PECOS PAC ID | 9537534177 |
|---|---|
| Medicare Enrollment ID | O20230412001370 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972138238 | NPI | - | NPPES |
| Provider Name | Jennifer A Janssen-st James |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215093612 PECOS PAC ID: 7315258407 Enrollment ID: I20170301002604 |
| Provider Name | Brieanne Marie Jennings |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013215029 PECOS PAC ID: 3476886995 Enrollment ID: I20190614000634 |
| Provider Name | Susan Lee |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124362694 PECOS PAC ID: 2769819606 Enrollment ID: I20200305001274 |
| Provider Name | Terry Lynn Surinsky |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740382241 PECOS PAC ID: 2466450325 Enrollment ID: I20230811000183 |
| Provider Name | Erica Khamvongsa |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1942705363 PECOS PAC ID: 8224481718 Enrollment ID: I20240131004115 |
| Provider Name | Karlie A Tepley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821511486 PECOS PAC ID: 4880032523 Enrollment ID: I20240401002460 |
| Provider Name | Mark Leon Willenbring |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003930124 PECOS PAC ID: 1850302597 Enrollment ID: I20240919001970 |
| Provider Name | Curran Mark Commerford |
|---|---|
| Provider Type | Practitioner - Psychologist Billing Independently |
| Provider Identifiers | NPI Number: 1528375847 PECOS PAC ID: 3577094283 Enrollment ID: I20241007000000 |
| Provider Name | Dairine Mary Pearson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952552614 PECOS PAC ID: 7618404609 Enrollment ID: I20250103000488 |
| Provider Name | Joann Spangler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063108660 PECOS PAC ID: 6901334606 Enrollment ID: I20250108003683 |
| Provider Name | Donald Lawrence Mauro |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1952629396 PECOS PAC ID: 6002345147 Enrollment ID: I20250117003375 |
| Provider Name | Alexandria Ayres |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1588035687 PECOS PAC ID: 3577092113 Enrollment ID: I20250127000660 |
| Provider Name | Forrest Hong |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679841001 PECOS PAC ID: 3870022387 Enrollment ID: I20250129001385 |
| Provider Name | Alexandra Sierra |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1992325278 PECOS PAC ID: 7113456625 Enrollment ID: I20250129001508 |
| Provider Name | Cameron Gabriel Lee |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255701975 PECOS PAC ID: 3375072887 Enrollment ID: I20250129001601 |
| Provider Name | Kimberly Anne Coshnear |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1437271921 PECOS PAC ID: 1052840576 Enrollment ID: I20250129001798 |
| Provider Name | Lan Wang |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1053561316 PECOS PAC ID: 3870022395 Enrollment ID: I20250129001807 |
| Provider Name | Deems Morrione |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366981664 PECOS PAC ID: 3779012299 Enrollment ID: I20250129001842 |
| Provider Name | Stacey Janelle Callis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366911505 PECOS PAC ID: 2365971884 Enrollment ID: I20250129001987 |
| Provider Name | Gregory Raul Gomez |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1205348968 PECOS PAC ID: 8628507142 Enrollment ID: I20250129002017 |
| Provider Name | Bernadet Yaghobian |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1467995449 PECOS PAC ID: 0345779765 Enrollment ID: I20250129002073 |
| Provider Name | William E. Watson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124511647 PECOS PAC ID: 2668901083 Enrollment ID: I20250129002250 |
| Provider Name | Megan E Scott |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1437336252 PECOS PAC ID: 5193254514 Enrollment ID: I20250129002354 |
| Provider Name | Jocelyn Volk Finn |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1174177240 PECOS PAC ID: 5597294926 Enrollment ID: I20250129002612 |
| Provider Name | Rachael Anne Forbes |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1184031056 PECOS PAC ID: 6406385830 Enrollment ID: I20250129002616 |
| Provider Name | Marian Ivarsson Marioni |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1457498156 PECOS PAC ID: 1557890985 Enrollment ID: I20250129002770 |
| Provider Name | Kandice Nicole Moore |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1609462316 PECOS PAC ID: 1557890993 Enrollment ID: I20250129002831 |
| Provider Name | Sandra D. Godfrey |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1093895153 PECOS PAC ID: 0345779781 Enrollment ID: I20250129002886 |
| Provider Name | Elizabeth Penelope Jacobo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578843686 PECOS PAC ID: 0648709097 Enrollment ID: I20250129003033 |
| Provider Name | Alejandra Guerrero |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700354263 PECOS PAC ID: 7719416163 Enrollment ID: I20250129003105 |
| Provider Name | Angelica Marie Rodriguez |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1386211175 PECOS PAC ID: 4486183837 Enrollment ID: I20250130000001 |
| Provider Name | Heather Markay Burdine |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487169744 PECOS PAC ID: 1759810120 Enrollment ID: I20250130000275 |
| Provider Name | John Choy |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1467887208 PECOS PAC ID: 8729517198 Enrollment ID: I20250130000342 |
| Provider Name | Dona J Clair |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1952597890 PECOS PAC ID: 4981133352 Enrollment ID: I20250130000420 |
| Provider Name | Marlayna Rattanapote |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1689816837 PECOS PAC ID: 7911436316 Enrollment ID: I20250130001572 |
| Provider Name | Kristalena Sauls |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245014588 PECOS PAC ID: 6103355417 Enrollment ID: I20250130002432 |
| Provider Name | Tamara Lynn Garner |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1356589089 PECOS PAC ID: 3274062583 Enrollment ID: I20250130002470 |
| Provider Name | Susan Hien Nguyen Lam |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1285825117 PECOS PAC ID: 2062941388 Enrollment ID: I20250130002699 |
| Provider Name | Elizabeth Ann Phelan Rohrer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598819831 PECOS PAC ID: 0042749368 Enrollment ID: I20250130002780 |
| Provider Name | Aryeh Yitzhak Lazar |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750801965 PECOS PAC ID: 6002345329 Enrollment ID: I20250130002979 |
| Provider Name | Wendy Nuessle |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770745341 PECOS PAC ID: 4981133212 Enrollment ID: I20250130003136 |
| Provider Name | Yanscy Flores |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407068125 PECOS PAC ID: 7517496847 Enrollment ID: I20250130003151 |
| Provider Name | Kristine Marie Hughes |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1649311010 PECOS PAC ID: 7113456443 Enrollment ID: I20250130003295 |
| Provider Name | Sylvia Guzman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851527220 PECOS PAC ID: 0840729174 Enrollment ID: I20250130003299 |
| Provider Name | Maral Pushian Sultanian |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1811025323 PECOS PAC ID: 2567991896 Enrollment ID: I20250130003319 |
| Provider Name | Linda Alcala |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1548763956 PECOS PAC ID: 3173052412 Enrollment ID: I20250130003524 |
| Provider Name | Jill Michelle Jackson |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1154538981 PECOS PAC ID: 6608305941 Enrollment ID: I20250130003629 |
| Provider Name | Brandy Ane Ziriax |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1144710963 PECOS PAC ID: 5294264552 Enrollment ID: I20250130004207 |
| Provider Name | Melissa Linda Bautista |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1053037515 PECOS PAC ID: 0446789713 Enrollment ID: I20250131000466 |
| Provider Name | David Michael Cayton |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1881133213 PECOS PAC ID: 4981133287 Enrollment ID: I20250131001521 |
| Provider Name | Mirna E Beltran |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760739221 PECOS PAC ID: 7416486618 Enrollment ID: I20250131001900 |
| Provider Name | Ji Eun Gina Midlam |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861791634 PECOS PAC ID: 0840729059 Enrollment ID: I20250131002483 |
| Provider Name | Dino Petruzzi |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1477953834 PECOS PAC ID: 1355870577 Enrollment ID: I20250131002719 |
| Provider Name | Elizabeth Marleen-butler Bevan |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1356869424 PECOS PAC ID: 8921537143 Enrollment ID: I20250131003011 |
| Provider Name | Catherine Blanche Castillo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588155170 PECOS PAC ID: 9335678564 Enrollment ID: I20250131003303 |
| Provider Name | Joanne Kathryn Talbot |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1750823928 PECOS PAC ID: 5698204873 Enrollment ID: I20250203001308 |
| Provider Name | Jason Allen Owens |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1689454886 PECOS PAC ID: 4385174598 Enrollment ID: I20250203003415 |
| Provider Name | Fatima Mendoza |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1780418574 PECOS PAC ID: 1456881689 Enrollment ID: I20250204000262 |
| Provider Name | Maribel Flores Hartford |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1881250413 PECOS PAC ID: 1254861412 Enrollment ID: I20250204001637 |
| Provider Name | Kristen Rene Bustillos Fragoso |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013447457 PECOS PAC ID: 8224568357 Enrollment ID: I20250205000908 |
| Provider Name | Rosalva Salerno |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710022488 PECOS PAC ID: 9739619875 Enrollment ID: I20250205001120 |
| Provider Name | Erin Fennell |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1083091094 PECOS PAC ID: 9931639085 Enrollment ID: I20250205001521 |
| Provider Name | Eric Llorente |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1750740296 PECOS PAC ID: 1658801543 Enrollment ID: I20250206003182 |
| Provider Name | Shena Lenore Crowe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467815290 PECOS PAC ID: 3072043967 Enrollment ID: I20250206003297 |
| Provider Name | Gary M Jordan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1790227957 PECOS PAC ID: 7012297963 Enrollment ID: I20250207001079 |
| Provider Name | Sylvia Petitt |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1265561237 PECOS PAC ID: 8022548965 Enrollment ID: I20250207001510 |
| Provider Name | Brittany Marie Evans |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1487938510 PECOS PAC ID: 4082144894 Enrollment ID: I20250210001115 |
| Provider Name | Kenji Michelle Jones |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1578901120 PECOS PAC ID: 5597295238 Enrollment ID: I20250210002585 |
| Provider Name | Erlene Kay Borden |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1821148040 PECOS PAC ID: 7911437678 Enrollment ID: I20250210003296 |
| Provider Name | Michael L Jackson |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1740478155 PECOS PAC ID: 1153851787 Enrollment ID: I20250211003002 |
| Provider Name | Jennifer Denise Jones |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417390220 PECOS PAC ID: 4587194113 Enrollment ID: I20250211003170 |
| Provider Name | Tara Maazel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336782853 PECOS PAC ID: 5597295105 Enrollment ID: I20250212001599 |
| Provider Name | Lisa Robin Whitmore |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669137287 PECOS PAC ID: 4587194915 Enrollment ID: I20250213003124 |
| Provider Name | William Everett Middleton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124725205 PECOS PAC ID: 1658801964 Enrollment ID: I20250214002558 |
| Provider Name | Andrea M Wasserman |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1902517345 PECOS PAC ID: 4486174794 Enrollment ID: I20250217002838 |
| Provider Name | Delmy Maria Portillo |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1811609019 PECOS PAC ID: 2567982762 Enrollment ID: I20250218003078 |
| Provider Name | Cherie Lynn Felzer |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1134641483 PECOS PAC ID: 4385164466 Enrollment ID: I20250219002254 |
| Provider Name | Natonya Scott |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1215515358 PECOS PAC ID: 2365888773 Enrollment ID: I20250220002206 |
| Provider Name | Wendi Lee Witherell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134695604 PECOS PAC ID: 1052831070 Enrollment ID: I20250220003615 |
| Provider Name | Robert Steven Conboy |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1780953778 PECOS PAC ID: 2163942046 Enrollment ID: I20250221002292 |
| Provider Name | Jesse Michael Marez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629164991 PECOS PAC ID: 2567982333 Enrollment ID: I20250224001595 |
| Provider Name | Tiffany Nicole Lewis-hill |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699239913 PECOS PAC ID: 6901280924 Enrollment ID: I20250303001490 |
| Provider Name | Veronica Marie Ewart |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770369597 PECOS PAC ID: 1951822089 Enrollment ID: I20250305003273 |
| Provider Name | Stephanie Rae Garris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780368480 PECOS PAC ID: 5294256327 Enrollment ID: I20250305003443 |
| Provider Name | Grethel Vanessa Vega |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497005789 PECOS PAC ID: 1355862335 Enrollment ID: I20250306001331 |
| Provider Name | Victor R Alcantar |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1457481772 PECOS PAC ID: 9537680533 Enrollment ID: I20250306002188 |
| Provider Name | Deborah Gay Corsaro |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1659613982 PECOS PAC ID: 4688195613 Enrollment ID: I20250306003046 |
| Provider Name | Michelle L. Powers |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1215566773 PECOS PAC ID: 7618498502 Enrollment ID: I20250307001823 |
| Provider Name | Chandra Sekhar Potnuru |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1780393314 PECOS PAC ID: 8921529561 Enrollment ID: I20250311003042 |
| Provider Name | Maryann Y Foster |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831169051 PECOS PAC ID: 8224192778 Enrollment ID: I20250311003468 |
| Provider Name | Mandi Ward |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386044725 PECOS PAC ID: 3577084136 Enrollment ID: I20250311003537 |
| Provider Name | Emily Mayer Mendez |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1275600678 PECOS PAC ID: 0244751782 Enrollment ID: I20250312003519 |
| Provider Name | Richard Henry Roth |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477790608 PECOS PAC ID: 9739321159 Enrollment ID: I20250313001389 |
| Provider Name | Lauresha Zinatae Hawkins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972936185 PECOS PAC ID: 7214459742 Enrollment ID: I20250313002705 |
Cucumber Wellness, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5201 Great America Pkwy Ste 320, Santa Clara, CA 95054 Phone: 833-427-3566 | |
Lucid Behavioral Health Pc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2556 Amethyst Dr, Santa Clara, CA 95051 Phone: 734-730-4218 | |
Best Steps Psychology P.c. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3170 De La Cruz Blvd Ste 111, Santa Clara, CA 95054 Phone: 669-292-5501 | |
Bill Wilson Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3490 The Alameda, Santa Clara, CA 95050 Phone: 408-850-6154 Fax: 408-246-5752 | |
Naama Magen Lugasi Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2811 Barcells Ave, Santa Clara, CA 95051 Phone: 408-618-9922 | |
Bill Wilson Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3490 The Alameda, Santa Clara, CA 95050 Phone: 408-278-2551 | |
Janet Johnston-tyler Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4655 Old Ironsides Dr., Suite 170, Santa Clara, CA 95054 Phone: 408-735-7990 Fax: 888-735-7991 |