SPREAD YOUR WINGS FOR MENTAL HEALTH INC. (NPI# 1760969539) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760969539 |
| Entity Type | Organization |
| Organization Name | SPREAD YOUR WINGS FOR MENTAL HEALTH INC. |
| Practice Address |
150 N Jackson Ave San Jose CA 95116-1908 |
| Mailing Address |
18106 Clementine Ct Lathrop CA 95330-8415 |
| Practice Telephone | 4084012984 |
| Enumeration Date | 2018-07-25 |
| Last Update Date | 2018-07-25 |
| Authorized Official Name | ANDREW SERRY DUMBUYA (CEO) |
| Authorized Official Telephone | 4084012984 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities | ||
| N | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities | ||
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| Street Address |
150 N JACKSON AVE |
| City | SAN JOSE |
| State | CA |
| Zip Code | 95116-1908 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417931114 | Ralph Stephen Zotovich | Dentist | 150 N Jackson Ave, Suite 110, San Jose, CA 95116-1908 | 2005-12-06 |
| 1679006209 | Reozel Realon Buquing, Dds, Inc. | Dentist | 150 N Jackson Ave, Suite 108, San Jose, CA 95116-1908 | 2017-04-11 |
| 1649673526 | San Jose Surgical Group | Surgery | 150 N Jackson Ave, Suite 100, San Jose, CA 95116-1908 | 2014-10-06 |
| 1316351216 | Don Allen Stevenson Dds Inc. | Dentist | 150 N Jackson Ave, Suite 204, San Jose, CA 95116-1908 | 2014-06-18 |
| 1629386198 | South Bay Gi Inc | Internal Medicine | 150 N Jackson Ave, Suite 107, San Jose, CA 95116-1908 | 2010-09-18 |
| 1427299098 | Dennis Terrak Calvert | Dentist | 150 N Jackson Ave, Suite 210, San Jose, CA 95116-1908 | 2009-03-11 |
| 1184899874 | Kelly De Gonzales | Surgery | 150 N Jackson Ave, Suite 100, San Jose, CA 95116-1908 | 2008-04-24 |
| 1912105917 | Gregory Rex Burnett | Dentist | 150 N Jackson Ave, #211, San Jose, CA 95116-1908 | 2007-07-11 |
| 1093928939 | Floro Bayle Ramirez | Dentist | 150 N Jackson Ave, Suite 108, San Jose, CA 95116-1908 | 2007-05-08 |
| 1427277342 | Michael Oran Bambico | Dentist | 150 N Jackson Ave, Suite # 103, San Jose, CA 95116-1908 | 2007-04-25 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821570102 | Lori Chung Cho Dmd Inc. | Clinic/Center | 150 N Jackson Ave Ste 103, San Jose, CA 95116 | 2018-09-03 |
| 1306333174 | Patrick Suezaki | Dentist | 250 Montclair Ave Ste C, San Jose, CA 95116 | 2018-04-17 |
| 1871016147 | Israel Enrique Ruiz Lora | Social Worker | 1075 East Santa Clara, San Jose, CA 95116 | 2017-07-19 |
| 1275072613 | Araceli Yazmin Garcia | Case Manager/Care Coordinator | 1652 E San Fernando St, San Jose, CA 95116 | 2017-02-17 |
| 1710304712 | Natalie K. Huynh D.d.s Inc. | Dentist | 2340 Mckee Rd #24, San Jose, CA 95116 | 2014-03-27 |
| 1437597747 | Ian Ellis Mccoy | Internal Medicine | 2360 Mckee Rd Ste 10, San Jose, CA 95116 | 2013-06-08 |
| 1588913321 | Adrian Fernandez | Counselor | 1245 East Santa Clara Street, San Jose, CA 95116 | 2012-09-07 |
| 1851678841 | Krystal Lani Subia | Counselor | 101 Jose Figueres Avenue, San Jose, CA 95116 | 2011-11-04 |
| 1255668224 | Sophia O.j.m. Dijkstra | Physical Therapist | 180 N. Jackson Ave, San Jose, CA 95116 | 2009-11-11 |
| 1255562096 | Jovan De Guzman Sedilla | Physical Therapy Assistant | 180 N. Jackson Ave., San Jose, CA 95116 | 2009-07-28 |
| Find all providers in zip 95116 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235593237 | Cielo House Inc | Clinic/Center | 334 N. Second St., San Jose, CA 95112 | 2016-04-06 |
| 1164835914 | Addiction Recovery Center | Clinic/Center | 3880 S. Bascom Ave #206, San Jose, CA 95124 | 2014-06-10 |
| 1275964488 | Indian Health Center of Santa Clara Valley | Clinic/Center | 1685 Westwood Dr Ste 1, San Jose, CA 95125 | 2013-12-13 |
| 1760584783 | County of Santa Clara | Clinic/Center | 650 South Bascom Avenue, San Jose, CA 95128 | 2006-09-01 |
| 1962512442 | County of Santa Clara | Clinic/Center | 2221 Enborg Lane, San Jose, CA 95128 | 2006-08-30 |
| 1497865976 | County of Santa Clara | Clinic/Center | 840 Guadalupe Pkwy, Suite 238, San Jose, CA 95110-1714 | 2006-08-30 |
| 1922118405 | County of Santa Clara | Clinic/Center | 828 S Bascom Ave Ste 180, San Jose, CA 95128-2600 | 2006-08-30 |
| 1437269917 | County of Santa Clara | Clinic/Center | 1650 Las Plumas Ave Ste K, San Jose, CA 95133-1657 | 2006-08-30 |
| 1699885079 | County of Santa Clara | Clinic/Center | 1887 Monterey Road Ste 205, San Jose, CA 95112-6192 | 2006-08-30 |
| 1679683064 | County of Santa Clara | Clinic/Center | 1075 East Santa Clara Street, San Jose, CA 95116 | 2006-08-30 |
| Find all providers in SAN JOSE | ||||
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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.