JULIAN STREET MEDICAL & MENTAL HEALTH SERVICES LLC (NPI# 1225454523) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225454523 |
| Entity Type | Organization |
| Organization Name | JULIAN STREET MEDICAL & MENTAL HEALTH SERVICES LLC |
| Practice Address |
804 E Julian St San Jose CA 95112-1876 |
| Mailing Address |
26460 Summit Cir Santa Clarita CA 91350-2991 |
| Practice Telephone | 4089756270 |
| Practice Fax Number | 4089756277 |
| Mailing Telephone | 6612546630 |
| Mailing Fax Number | 6612546644 |
| Enumeration Date | 2014-03-11 |
| Last Update Date | 2014-03-11 |
| Authorized Official Name | STAN SHARMA (MANAGER) |
| Authorized Official Telephone | 6612546630 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2800X |
Clinic/Center Specialization: Methadone Clinic |
CA | Ambulatory Health Care Facilities |
| Street Address |
804 E JULIAN ST |
| City | SAN JOSE |
| State | CA |
| Zip Code | 95112-1876 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821094814 | Hien Quy Pham | Pharmacist | 804 E Julian St, Ste C, San Jose, CA 95112-1809 | 2005-06-23 |
| 1376506550 | Hien Thi Pham | Internal Medicine | 804 E Julian St, Suite D, San Jose, CA 95112-1809 | 2006-04-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104443407 | Khady Fall | Behavior Technician | 408 494 1561, 614 Tully Road, San Jose, CA 95112 | 2020-07-02 |
| 1538791124 | Vianey Martinez | Social Worker | 290 N Second Street, San Jose, CA 95112 | 2020-02-11 |
| 1083254262 | Tessa Dobrin Zapalac | Behavior Technician | 1887 Monterey Road, Suite 225, San Jose, Ca 95112, San Jose, CA 95112 | 2020-01-15 |
| 1508404716 | Emilie Caitlin Leach | Counselor | 290 N 2nd St, San Jose, CA 95112 | 2019-12-18 |
| 1699313080 | Juan Carlos Mercado | Marriage & Family Therapist | 290 North 2nd St, San Jose, CA 95112 | 2019-12-16 |
| 1386288017 | Path (people Assisting The Homeless) | Case Manager/Care Coordinator | 290 N. 2nd Street San Jose Ca, San Jose, CA 95112 | 2019-11-06 |
| 1316588528 | Loralee Crystal Garcia | Technician | 546 N. 3rd Street #7, San Jose, CA 95112 | 2019-09-30 |
| 1306316922 | Patricia Calatraba Swofford | Marriage & Family Therapist | 232 E. Gish Rd., San Jose, CA 95112 | 2018-11-27 |
| 1134606932 | Ana Alicia Castro-banderas | Social Worker | 160 E Virginia St., Suite 100, San Jose, CA 95112 | 2018-07-24 |
| 1275035750 | Theresa Khong | Behavior Technician | 1887 Monterey Hwy. Suite 225, San Jose, CA 95112 | 2018-03-01 |
| Find all providers in zip 95112 | ||||
| Taxonomy Code | 261QM2800X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Methadone Clinic |
| An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932379021 | Santa Clara County | Clinic/Center | 2425 Enborg Ln, San Jose, CA 95128-2648 | 2008-03-05 |
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|---|---|---|---|---|
| 1083224141 | Aegis Treatment Centers, LLC | Clinic/Center | 1450 Bessie Ave Ste B, Tracy, CA 95376-3456 | 2020-08-04 |
| 1093323222 | City and County of San Francisco | Clinic/Center | 1001 Potrero Ave # Ward86, San Francisco, CA 94110-3518 | 2020-07-14 |
| 1548899644 | Bella Team Ltd. | Clinic/Center | 2618 San Miguel Dr Ste 1288, Newport Beach, CA 92660-5437 | 2020-04-02 |
| 1386280899 | Western Pacific Med-corp | Clinic/Center | 26921 Crown Valley Pkwy Ste 200, Mission Viejo, CA 92691-6501 | 2019-11-19 |
| 1518501527 | Harmonic Solutions LLC | Clinic/Center | 1776 Ygnacio Valley Rd Ste 206, Walnut Creek, CA 94598-3125 | 2019-11-01 |
| 1326698887 | Aegis Treatment Centers, LLC | Clinic/Center | 2107, 2109 & 2113 1st St, Eureka, CA 95501-0840 | 2019-09-17 |
| 1548819550 | Aegis Treatment Centers, LLC | Clinic/Center | 1111 W Inyokern Rd Ste B, Ridgecrest, CA 93555-2370 | 2019-09-11 |
| 1306326699 | Kristen Andree Rickard | Clinic/Center | 1153 Paradise Trail Rd, Chula Vista, CA 91915-2502 | 2018-08-16 |
| 1083141600 | Baart Behavioral Health Services, Inc. | Clinic/Center | 1145 Market St Fl 10, San Francisco, CA 94103-1566 | 2017-05-13 |
| 1013448547 | Coachella Valley Treatment Center | Clinic/Center | 81709 Dr Carreon Blvd Ste B1, Indio, CA 92201-5510 | 2017-03-26 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.