Provider Demographics
NPI:1376066787
Name:AMOROSO, NOEL C (ASW)
Entity Type:Individual
Prefix:
First Name:NOEL
Middle Name:C
Last Name:AMOROSO
Suffix:
Gender:M
Credentials:ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 UNION AVE APT 255B
Mailing Address - Street 2:
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95008-4265
Mailing Address - Country:US
Mailing Address - Phone:808-754-5416
Mailing Address - Fax:
Practice Address - Street 1:921 S 1ST ST # B
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95110-3126
Practice Address - Country:US
Practice Address - Phone:408-590-4605
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-18
Last Update Date:2017-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA72670101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health