SPREAD YOUR WINGS LLC (NPI# 1376020313) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376020313 |
| Entity Type | Organization |
| Organization Name | SPREAD YOUR WINGS LLC |
| Practice Address |
150 N Jackson Ave Ste 10 San Jose CA 95116-1908 |
| Mailing Address |
96 W 2nd St Morgan Hill CA 95037-4504 |
| Enumeration Date | 2018-07-23 |
| Last Update Date | 2018-07-23 |
| Authorized Official Name | ANDREW SERRY DUMBUYA (CEO) |
| Authorized Official Telephone | 4084012984 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 104100000X | Social Worker | Behavioral Health & Social Service Providers | ||
| N | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities | ||
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities |
| Street Address |
150 N JACKSON AVE STE 10 |
| City | SAN JOSE |
| State | CA |
| Zip Code | 95116-1908 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821570102 | Lori Chung Cho Dmd Inc. | Clinic/Center | 150 N Jackson Ave Ste 103, San Jose, CA 95116 | 2018-09-03 |
| 1306333174 | Patrick Suezaki | Dentist | 250 Montclair Ave Ste C, San Jose, CA 95116 | 2018-04-17 |
| 1871016147 | Israel Enrique Ruiz Lora | Social Worker | 1075 East Santa Clara, San Jose, CA 95116 | 2017-07-19 |
| 1275072613 | Araceli Yazmin Garcia | Case Manager/Care Coordinator | 1652 E San Fernando St, San Jose, CA 95116 | 2017-02-17 |
| 1710304712 | Natalie K. Huynh D.d.s Inc. | Dentist | 2340 Mckee Rd #24, San Jose, CA 95116 | 2014-03-27 |
| 1437597747 | Ian Ellis Mccoy | Internal Medicine | 2360 Mckee Rd Ste 10, San Jose, CA 95116 | 2013-06-08 |
| 1588913321 | Adrian Fernandez | Counselor | 1245 East Santa Clara Street, San Jose, CA 95116 | 2012-09-07 |
| 1851678841 | Krystal Lani Subia | Counselor | 101 Jose Figueres Avenue, San Jose, CA 95116 | 2011-11-04 |
| 1255668224 | Sophia O.j.m. Dijkstra | Physical Therapist | 180 N. Jackson Ave, San Jose, CA 95116 | 2009-11-11 |
| 1255562096 | Jovan De Guzman Sedilla | Physical Therapy Assistant | 180 N. Jackson Ave., San Jose, CA 95116 | 2009-07-28 |
| Find all providers in zip 95116 | ||||
| Taxonomy Code | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881083863 | Sunrise Rcfe Inc | Clinic/Center | 32 N 21st St, San Jose, CA 95116-1102 | 2015-01-14 |
| 1356638050 | Healthright 360 | Clinic/Center | 760 Hillsdale Ave, San Jose, CA 95136-1106 | 2011-07-01 |
| 1487288874 | Healthright 360 | Clinic/Center | 1750 S White Rd, San Jose, CA 95127-4760 | 2020-02-25 |
| 1760969539 | Spread Your Wings for Mental Health Inc. | Clinic/Center | 150 N Jackson Ave, San Jose, CA 95116-1908 | 2018-07-25 |
| 1467813840 | Brain Tms LLC | Clinic/Center | 2516 Samaritan Dr, Suite M, San Jose, CA 95124-4108 | 2016-03-14 |
| 1538529052 | Indian Health Center of Santa Clara Valley | Clinic/Center | 25 N 14th St Ste 140, San Jose, CA 95112-6218 | 2016-02-25 |
| 1558523035 | Riviera Evp, Oasis Care | Clinic/Center | 101 Jose Figueres Ave, San Jose, CA 95116-2022 | 2008-06-26 |
| 1255409314 | Healthright 360 | Clinic/Center | 1340 Tully Rd, Suite 301 & 304, San Jose, CA 95122-3055 | 2006-11-30 |
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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.