Clyde Ellis Virges, CADC II09181953

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

E0312796 Issued in CA

Practice address

614 Tully Rd
San Jose, CA 95111-1048

Phone

(408) 977-1591

Fax

(408) 977-1136

NPI assigned

Mar 16, 2011

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1300233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300233600000",
    "number": "1134428162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "614 TULLY RD",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951111048",
            "telephone_number": "408-977-1591",
            "fax_number": "408-977-1136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "614 TULLY RD",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951111048",
            "telephone_number": "408-977-1591",
            "fax_number": "408-977-1136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIRGES",
        "first_name": "CLYDE",
        "middle_name": "ELLIS",
        "credential": "CADC II09181953",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-03-16",
        "last_updated": "2011-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "E0312796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Montserrat Carolynn Viramontes
• Christopher Q Viray, D.D.S.
• Lota F. Viray, M.D.
• Rachel Guintu Viray, LVN
• Isabel Virga
• Jasbir Kaur Virk, MD
• Simreen Virk
• Taproop Virk, DDS
• Vineet Virk
• Keane Virola

• Addiction (Substance Use Disorder) Counselor in San Jose, CA
• Providers in San Jose, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.