NPIMap

Organization Active NPI

Grace Community Center

  • Community/Behavioral Health Agency
  • San Jose, CA
National Provider Identifier
1871758896
Registry record updated Jul 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
GRACE COMMUNITY CENTER
Practice address
484 E San Fernando St
San Jose, CA 95112-3513
Phone
(408) 293-0422
NPI assigned
Jul 21, 2008
Organization subpart
Yes
Parent organization
CITY OF SAN JOSEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 21, 2008

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

Authorized official

Name
Dr. Lisa Ann Blevins, PH.D.
Title
Therapeutic Service Manager
Phone
(408) 293-0422

Specialties & licenses 1

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

Addresses

Primary practice location

484 E San Fernando St
San Jose, CA 95112-3513

Mailing address

484 E San Fernando St
San Jose, CA 95112-3513
Phone (408) 293-0422

Other identifiers 1

IdentifierTypeStateIssuer
42502OtherCAPARCCA

National Provider Directory

National Provider Directory
Tax ID family
City of San Jose5 organizations share this tax ID, including this one
Part of
City of San Jose

Other organizations with this tax ID 4

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1216598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216598400000",
    "number": "1871758896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "484 E SAN FERNANDO ST",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951123513",
            "telephone_number": "408-293-0422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "484 E SAN FERNANDO ST",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951123513",
            "telephone_number": "408-293-0422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE COMMUNITY CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CITY OF SAN JOSE",
        "enumeration_date": "2008-07-21",
        "last_updated": "2008-07-21",
        "status": "A",
        "authorized_official_last_name": "BLEVINS",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "THERAPEUTIC SERVICE MANAGER",
        "authorized_official_telephone_number": "408-293-0422",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARCCA",
            "identifier": "42502",
            "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 Jul 21, 2008; 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.