Provider Demographics
NPI:1952664526
Name:CATHOLIC CHARITIES OF SANTA CLARA COUNTY
Entity Type:Organization
Organization Name:CATHOLIC CHARITIES OF SANTA CLARA COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:KEPFERLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-325-1114
Mailing Address - Street 1:2625 ZANKER RD
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95134-2130
Mailing Address - Country:US
Mailing Address - Phone:408-325-5120
Mailing Address - Fax:
Practice Address - Street 1:195 E SAN FERNANDO ST
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95112-3503
Practice Address - Country:US
Practice Address - Phone:408-325-5120
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-19
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health