Provider Demographics
NPI:1346399771
Name:PIETROMONACO, JOSEPH (PHD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:PIETROMONACO
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5755 COTTLE RD BLDG 4
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95123-3640
Mailing Address - Country:US
Mailing Address - Phone:408-972-3238
Mailing Address - Fax:
Practice Address - Street 1:5755 COTTLE RD BLDG 4
Practice Address - Street 2:KAISER SANTA TERESA PSYCHIATRY DEPARTMENT
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95123-3640
Practice Address - Country:US
Practice Address - Phone:408-972-3238
Practice Address - Fax:408-972-3242
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY10700103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist