STATE OF CALIFORNIA - DEPARTMENT OF DEVELOPMENTAL SERVICES NPI 1730130071

NPI Information

STATE OF CALIFORNIA - DEPARTMENT OF DEVELOPMENTAL SERVICES is an intermediate care facility mentally retarded in San Jose, CA. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. STATE OF CALIFORNIA - DEPARTMENT OF DEVELOPMENTAL SERVICES NPI is 1730130071. The provider is registered as an organization entity type.
The provider Is Doing Business As Agnews Developmental Center.

The provider's business location address is:

3500 ZANKER RD
SAN JOSE, CA
ZIP 95134-201
Phone: (408) 451-6198
Fax: (408) 451-6167

The provider's authorized official is Kathy Kinser .
The authorized official title is Deputy Director and has the following contact phone number (916) 654-1963.

The enumeration date for this NPI number is 5/12/2006 and was last updated on 1/6/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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