Provider Demographics
NPI:1053832808
Name:WILLIAM C. KLINDT, M.D. INC.
Entity Type:Organization
Organization Name:WILLIAM C. KLINDT, M.D. INC.
Other - Org Name:CLEAR MINDS INTEGRATIVE MENTAL HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:C
Authorized Official - Last Name:KLINDT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:408-690-1573
Mailing Address - Street 1:3880 S BASCOM AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95124-2675
Mailing Address - Country:US
Mailing Address - Phone:408-690-1573
Mailing Address - Fax:
Practice Address - Street 1:15215 NATIONAL AVE STE 101
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-2425
Practice Address - Country:US
Practice Address - Phone:408-690-1573
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WILLIAM C. KLINDT, M.D. INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-07-02
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA91270106H00000X
CAG690582084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1679874960OtherNPI
CA1124235569OtherNPI NUMBER