| Willow Glen High | |
|
160 E Virginia St Ste 280 San Jose CA 95112-5817 | |
| (408) 287-6200 | |
| Not Available |
| Full Name | Willow Glen High |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 160 E Virginia St Ste 280, San Jose, California |
| Authorized Official Name and Position | Loren Gissible (PROGRAM COORDINATOR) |
| Authorized Official Contact | 4082876200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Willow Glen High 2001 Cottle Ave San Jose CA 95125-3502 Ph: (408) 287-6200 | Willow Glen High 160 E Virginia St Ste 280 San Jose CA 95112-5817 Ph: (408) 287-6200 |
| NPI Number | 1194172122 |
|---|---|
| Provider Enumeration Date | 05/19/2016 |
| Last Update Date | 05/19/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194172122 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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