NPIMap

Organization Active NPI

VA

  • Psychiatric Hospital Unit
  • San Jose, CA
National Provider Identifier
1417387002
Registry record updated Nov 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
License
ASW59763 Issued in CA
Legal business name
VA
Practice address
80 Great Oaks Blvd
San Jose, CA 95119
Phone
(650) 493-5000
NPI assigned
Nov 18, 2013
Last updated
Nov 18, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2013

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

Authorized official

Name
Mr. Jimmmie Thompson, ASW
Title
Social Worker
Phone
(650) 468-5805

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X ASW59763 CA Primary

Addresses

Primary practice location

80 Great Oaks Blvd
San Jose, CA 95119

Mailing address

80 Great Oaks Blvd
San Jose, CA 95119-1310
Phone (650) 493-5000

Other names 1

  • Vetrans Affire Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Gayle Witham456 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1384732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384732800000",
    "number": "1417387002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 GREAT OAKS BLVD",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951191310",
            "telephone_number": "650-493-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 GREAT OAKS BLVD",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "95119",
            "telephone_number": "650-493-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-18",
        "last_updated": "2013-11-18",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "JIMMMIE",
        "authorized_official_title_or_position": "SOCIAL WORKER",
        "authorized_official_telephone_number": "650-468-5805",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "ASW"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "CA",
            "license": "ASW59763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vetrans Affire",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Nov 18, 2013; 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.