NPIMap

Organization Active NPI

Starlight Adolescent Center

  • Community/Behavioral Health Agency
  • San Jose, CA
National Provider Identifier
1306938402
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
STARLIGHT ADOLESCENT CENTER
Practice address
455 Silicon Valley Blvd
San Jose, CA 95138-1858
Phone
(408) 284-9000
Fax
(408) 284-9048
NPI assigned
Sep 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mary Jane Gross, RN, MA
Title
President
Phone
(510) 635-9705

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X CA Primary

Addresses

Primary practice location

455 Silicon Valley Blvd
San Jose, CA 95138-1858

Mailing address

455 Silicon Valley Blvd
San Jose, CA 95138-1858
Phone (408) 284-9000

Other identifiers 2

IdentifierTypeStateIssuer
43AGOtherCASANTA CLARA CTY. MED PROV
2215524OtherCASTATE CORP #

National Provider Directory

National Provider Directory
Tax ID family
Starlight Adolescent Center14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1306938402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 SILICON VALLEY BLVD",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951381858",
            "telephone_number": "408-284-9000",
            "fax_number": "408-284-9048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 SILICON VALLEY BLVD",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951381858",
            "telephone_number": "408-284-9000",
            "fax_number": "408-284-9048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STARLIGHT ADOLESCENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GROSS",
        "authorized_official_first_name": "MARY JANE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "510-635-9705",
        "authorized_official_credential": "RN, MA"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SANTA CLARA CTY. MED PROV",
            "identifier": "43AG",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE CORP #",
            "identifier": "2215524",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.