Provider Demographics
NPI:1790482107
Name:COUNTY OF SANTA CLARA
Entity Type:Organization
Organization Name:COUNTY OF SANTA CLARA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, BEHAVIORAL HEALTH SVCS
Authorized Official - Prefix:
Authorized Official - First Name:SHERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:TERAO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-885-5776
Mailing Address - Street 1:828 S BASCOM AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-2600
Mailing Address - Country:US
Mailing Address - Phone:408-885-5770
Mailing Address - Fax:
Practice Address - Street 1:591 N KING RD STE 3
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95133-1661
Practice Address - Country:US
Practice Address - Phone:408-793-8972
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF SANTA CLARA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-02-15
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)