STARLIGHT ADOLESCENT CENTER (NPI# 1306938402) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306938402 |
| Entity Type | Organization |
| Organization Name | STARLIGHT ADOLESCENT CENTER |
| Practice Address |
455 Silicon Valley Blvd San Jose CA 95138-1858 |
| Practice Telephone | 4082849000 |
| Practice Fax Number | 4082849048 |
| Mailing Telephone | 4082849000 |
| Mailing Fax Number | 4082849048 |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MARY JANE GROSS (PRESIDENT) |
| Authorized Official Telephone | 5106359705 |
| Authorized Official Credential | RN, MA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | CA | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | STATE CORP # | 2215524 | 01 |
| CA | SANTA CLARA CTY. MED PROV | 43AG | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396913349 | Starlight Adolescent Center | Psychiatric Hospital | 5824 Chris Dr, San Jose, CA 95123-3501 | 2008-02-12 |
| Street Address |
455 SILICON VALLEY BLVD |
| City | SAN JOSE |
| State | CA |
| Zip Code | 95138-1858 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124681127 | Kruti Rawal | Pharmacist | 455 Silicon Valley Blvd, San Jose, CA 95138-1858 | 2019-04-16 |
| 1144600784 | Ana Lopez Rojas | Counselor | 455 Silicon Valley Blvd, San Jose, CA 95138-1858 | 2015-06-08 |
| 1508252149 | Sjbh, LLC | Psychiatric Hospital | 455 Silicon Valley Blvd, San Jose, CA 95138-1858 | 2015-04-10 |
| 1053632059 | Nathaniel Grant Sharon | Psychiatry & Neurology | 455 Silicon Valley Blvd, San Jose, CA 95138-1858 | 2010-06-14 |
| 1477784775 | Crystal Estrada | Counselor | 455 Silicon Valley Blvd, San Jose, CA 95138-1858 | 2009-08-04 |
| 1508039124 | Peter Hernandez | Counselor | 455 Silicon Valley Blvd, San Jose, CA 95138-1858 | 2008-04-03 |
| 1841460995 | Lashurn Michelle Ferrell | Counselor | 455 Silicon Valley Blvd, Human Resources, San Jose, CA 95138-1858 | 2008-03-05 |
| 1376712174 | John Mark Kane | Counselor | 455 Silicon Valley Blvd, San Jose, CA 95138-1858 | 2008-02-26 |
| 1154599892 | Mei-yan Chiang | Counselor | 455 Silicon Valley Blvd, San Jose, CA 95138-1858 | 2008-02-15 |
| 1013197052 | Debra Lee Collins | Residential Treatment Facility, Emotionally Disturbed Children | 455 Silicon Valley Blvd, San Jose, CA 95138-1858 | 2007-11-07 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023623865 | Nguyen and Tran Dental Corporation | Dentist | 6130 Hellyer Avenue, San Jose, CA 95138 | 2020-09-09 |
| 1821564485 | Indian Health Center of Santa Clara Valley | Clinic/Center | 9501 Malech Rd, San Jose, CA 95138 | 2018-10-22 |
| 1548690324 | Megan Chang | Occupational Therapist | 5900, Pistoia Way, San Jose, CA 95138 | 2013-11-15 |
| 1720428410 | Cristina Duenas | Social Worker | 5855 Silver Creek Valley Pl, San Jose, CA 95138 | 2013-06-27 |
| 1174967079 | Guardian Sleep Clinic, LLC | Clinical Medical Laboratory | 315 Piercy Rd, San Jose, CA 95138 | 2013-04-22 |
| 1871847889 | Rebecca Kerry Van Sickle | Counselor | 9500 Malech Rd, San Jose, CA 95138 | 2012-10-30 |
| 1366720906 | Ariosa Diagnostics, Inc. | Clinical Medical Laboratory | 5945 Optical Court, San Jose, CA 95138 | 2011-08-01 |
| 1043406713 | Umaru Fofana | Counselor | 455 Silicon Valley Blvd, San Jose, CA 95138 | 2007-09-17 |
| 1316140569 | Dickman & Bourla Chiropractic Inc | Chiropractor | 2311 Silver Breeze Ct, San Jose, CA 95138 | 2007-06-06 |
| 1508983032 | Traci Pickett | Counselor | 9500 Malech Road, San Jose, CA 95138 | 2007-03-22 |
| Find all providers in zip 95138 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447718838 | Alum Rock Counseling Center | Community/Behavioral Health | 234 E Gish Rd Ste 200, San Jose, CA 95112-4724 | 2019-03-05 |
| 1184189722 | Uplift Family Services | Community/Behavioral Health | 653 Sylvandale Ave, San Jose, CA 95111-1414 | 2019-02-07 |
| 1386126621 | Alum Rock Counseling Center | Community/Behavioral Health | 14281 Story Road, San Jose, CA 95127 | 2018-09-04 |
| 1194218149 | Catholic Charities of Santa Clara County | Community/Behavioral Health | 2150 Alum Rock Ave, San Jose, CA 95116-2054 | 2018-06-13 |
| 1306336102 | Unity Care Group, Inc. | Community/Behavioral Health | 469 Delridge Dr, San Jose, CA 95111-1703 | 2018-05-16 |
| 1295230969 | Caminar | Community/Behavioral Health | 2202 N 1st St Ste 2210, San Jose, CA 95131-2007 | 2018-03-26 |
| 1487175485 | Arise Services | Community/Behavioral Health | 1009 E Capitol Expy # 407, San Jose, CA 95121-2415 | 2017-06-29 |
| 1811438765 | Family and Children Services A Division of Caminar | Community/Behavioral Health | 109 E Gish Rd, San Jose, CA 95112-4702 | 2017-03-12 |
| 1073052734 | County of Santa Clara | Community/Behavioral Health | 4825 Speak Ln, San Jose, CA 95118-3769 | 2017-02-14 |
| 1164965034 | Alum Rock Counseling Center, Inc. | Community/Behavioral Health | 1944 Flint Ave, San Jose, CA 95148-1213 | 2016-11-28 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.