Provider Demographics
NPI:1417220914
Name:ASPIRA WELLNESS AND EDUCATION
Entity Type:Organization
Organization Name:ASPIRA WELLNESS AND EDUCATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEVELOPMENTAL SUPERVISOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:408-802-1015
Mailing Address - Street 1:588 BLOSSOM HILL RD STE A
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95123-3211
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:588 BLOSSOM HILL RD STE A
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95123-3211
Practice Address - Country:US
Practice Address - Phone:408-802-1015
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ASPIRANET
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-02-14
Last Update Date:2012-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health