Provider Demographics
NPI:1255152195
Name:FARLEY, JOHN J (PSYD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:J
Last Name:FARLEY
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1030 E EL CAMINO REAL # 322
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94087-3841
Mailing Address - Country:US
Mailing Address - Phone:408-688-4596
Mailing Address - Fax:
Practice Address - Street 1:2170 THE ALAMEDA
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95126-1131
Practice Address - Country:US
Practice Address - Phone:408-688-4596
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-23
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach