Provider Demographics
NPI:1053140871
Name:ALUM ROCK COUNSELING CENTER, INC.
Entity type:Organization
Organization Name:ALUM ROCK COUNSELING CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:MELGOZA
Authorized Official - Last Name:GAMBOA
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:408-771-1734
Mailing Address - Street 1:1245 E SANTA CLARA ST
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95116-2337
Mailing Address - Country:US
Mailing Address - Phone:408-294-0500
Mailing Address - Fax:408-293-2317
Practice Address - Street 1:5345 AVENIDA ALMENDROS
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95123-1499
Practice Address - Country:US
Practice Address - Phone:408-225-5675
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-30
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health