NPIMap

Organization Active NPI

Crestwood Behavioral Health, Inc.

  • Assisted Living Facility (Mental Illness)
  • San Jose, CA
National Provider Identifier
1720157050
Registry record updated May 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X
Legal business name
CRESTWOOD BEHAVIORAL HEALTH, INC.
Practice address
1425 Fruitdale Ave
San Jose, CA 95128-3234
Phone
(408) 275-1010
Fax
(408) 275-1066
NPI assigned
Nov 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2025

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

Authorized official

Name
Michelle Smith
Title
Executive Director Reimbursement
Phone
(209) 955-2316

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility (Mental Illness) 3104A0625X Primary

Addresses

Primary practice location

1425 Fruitdale Ave
San Jose, CA 95128-3234

Mailing address

7590 Shoreline Dr
Stockton, CA 95219-5455
Phone (209) 955-2328

Other names 1

  • CRESTWOOD CENTER Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Crestwood Behavioral Health71 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": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747699200000",
    "number": "1720157050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7590 SHORELINE DR",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952195455",
            "telephone_number": "209-955-2328",
            "fax_number": "209-952-5314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 FRUITDALE AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951283234",
            "telephone_number": "408-275-1010",
            "fax_number": "408-275-1066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESTWOOD BEHAVIORAL HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2025-05-20",
        "certification_date": "2025-05-20",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR REIMBURSEMENT",
        "authorized_official_telephone_number": "209-955-2316"
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CRESTWOOD CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 May 20, 2025; 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.