Willow Glen High

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

WILLOW GLEN HIGH

Practice address

160 E Virginia St Ste 280
San Jose, CA 95112-5817

Phone

(408) 287-6200

NPI assigned

May 19, 2016

Organization subpart

Yes

Parent organization

GARDNER FAMILY CARE CORPORATIOAs reported in NPPES

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

Authorized official

Name

Loren Gissible, LCSW

Title

Program Coordinator

Phone

(408) 287-6200

Specialties & licenses 1

Addresses

Tax ID family

Willow Glen High2 organizations share this tax ID, including this one

Part of

Allen at Steinbeck

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Willow Glen Middle School

  • Community/Behavioral Health Agency
  • San Jose, CA
  • NPI 1043667074
  NPD tax ID

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

{
    "created_epoch": "1463616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463616000000",
    "number": "1194172122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 COTTLE AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951253502",
            "telephone_number": "408-287-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 E VIRGINIA ST STE 280",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951125817",
            "telephone_number": "408-287-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOW GLEN HIGH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GARDNER FAMILY CARE CORPORATIO",
        "enumeration_date": "2016-05-19",
        "last_updated": "2016-05-19",
        "status": "A",
        "authorized_official_last_name": "GISSIBLE",
        "authorized_official_first_name": "LOREN",
        "authorized_official_title_or_position": "PROGRAM COORDINATOR",
        "authorized_official_telephone_number": "408-287-6200",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Willmes
• Carol Willoughby, R.N.
• Willow Anxiety and Ocd
• Willow Glen Chiropractic
• Willow Glen Dental Specialists
• Willow Glen Middle School
• Willow Glen Optm Physical Therapy
• Willow Glen Primary Care Medicine
• Willow Home Health Care Services, Inc
• Kathleen Anne Wills, B.A.

• Community/Behavioral Health Agency in San Jose, CA
• Providers in San Jose, CA by specialty
• Community/Behavioral Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2016; 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.