JACQUELINE SARELLANO-MORENO (NPI# 1639688682) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639688682 |
| Entity Type | Individual |
| Full Name | JACQUELINE SARELLANO-MORENO |
| Practice Address |
1340 Tully Rd Suite 301 San Jose CA 95122 |
| Mailing Address |
1340 Tully Rd Ste 301 San Jose CA 95122-3055 |
| Practice Telephone | (408) 271-3900 |
| Mailing Telephone | 4082713900 |
| Enumeration Date | 2017-09-21 |
| Last Update Date | 2017-09-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| Street Address |
1340 TULLY RD SUITE 301 |
| City | SAN JOSE |
| State | CA |
| Zip Code | 95122 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831104470 | Prescription Headquarters Inc | Pharmacy | 1340 Tully Rd, Ste 312, San Jose, CA 95122-3055 | 2006-07-30 |
| 1114561875 | Eufrosina A Gates | Counselor | 1340 Tully Rd, San Jose, CA 95122-3055 | 2019-11-05 |
| 1902371008 | Bryan Yukiu Leung | Student in an Organized Health Care Education/Training Program | 1340 Tully Rd, San Jose, CA 95122-3055 | 2018-10-04 |
| 1306365614 | Jessica Page | Counselor | 1340 Tully Rd, San Jose, CA 95122-3055 | 2017-09-18 |
| 1508318890 | Jie Yu | Counselor | 1340 Tully Rd, San Jose, CA 95122-3055 | 2016-11-02 |
| 1306397393 | Shaochen Chang | Counselor | 1340 Tully Rd, San Jose, CA 95122-3055 | 2016-10-14 |
| 1255782041 | Sarina Huerta | Counselor | 1340 Tully Rd, San Jose, CA 95122 | 2016-06-23 |
| 1851750269 | Brittany Simons | Counselor | 1340 Tully Rd, San Jose, CA 95122-3055 | 2016-02-12 |
| 1669846028 | Sinh Le | Counselor | 1340 Tully Rd, Suite 304, San Jose, CA 95122-3055 | 2015-11-23 |
| 1801265335 | Jenny Le | Counselor | 1340 Tully Rd, Ste 304, San Jose, CA 95122-3055 | 2015-09-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437788015 | Vietnam Pharmacy Inc | Pharmacy | 2451 S King Rd Suite A1, San Jose, CA 95122 | 2020-04-06 |
| 1346894524 | Amy Le Tran | Counselor | Mekong Community Center, 2203 Tully Road, San Jose, CA 95122 | 2019-07-26 |
| 1164980439 | Tri Starr Home Care, LLC | PACE Provider Organization | 1609 Flanigan Dr., Unit H, Unit H, San Jose, CA 95122 | 2019-03-06 |
| 1740761196 | Aileen Phu | Acupuncturist | 1271 Story Rd Ste 50, San Jose, CA 95122 | 2018-08-23 |
| 1740775816 | Urgent Care Clinic of Northern Ca Inc | Clinic/Center | 999 Story Road, Suite 9021, San Jose, CA 95122 | 2018-06-29 |
| 1952825911 | Robert Martin Thomas | Counselor | 950 Julian St, San Jose, CA 95122 | 2017-08-01 |
| 1497113153 | Jamealle Spain | Case Manager/Care Coordinator | 2070 Lucretia Ave #310, San Jose, CA 95122 | 2016-02-09 |
| 1770915035 | Thinh Tran | Dentist | 919 Story Rd Unit 1128, San Jose, CA 95122 | 2013-08-08 |
| 1356591333 | Asian American Recovery Services | Counselor | 1340 Tully Rd., San Jose, CA 95122 | 2008-09-25 |
| 1821246505 | Samara Rachel Stone | Marriage & Family Therapist | 1340 Tully Road, Suite 304, San Jose, CA 95122 | 2008-09-05 |
| Find all providers in zip 95122 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912507021 | Lucid Lane Providers, P.C. | Counselor | 3251 Place Du Jardin, Optional, San Jose, CA 95148-9514 | 2020-10-28 |
| 1700491800 | Sean Garcia | Counselor | 2959 Carrington Ct, San Jose, CA 95125-4882 | 2020-09-15 |
| 1659985240 | Meng Chang Licensed Marriage and Family Therapist | Counselor | 1174 Lincoln Ave Ste 8, San Jose, CA 95125-3029 | 2020-09-02 |
| 1932721115 | Ellen C Gagne | Counselor | 290 N 2nd St Ste 202, San Jose, CA 95112-4143 | 2020-05-11 |
| 1215566773 | Michelle L. Powers | Counselor | 2 N Market St Ste 500, San Jose, CA 95113-1211 | 2020-04-06 |
| 1841823069 | Ana Gabriella Marquez | Counselor | 298 Bernal Rd # A, San Jose, CA 95119-1809 | 2020-02-17 |
| 1063044741 | Alyssa N Thompson | Counselor | 423 Los Arboles St, San Jose, CA 95111-2344 | 2020-02-10 |
| 1336770288 | Genevieve Altwer | Counselor | 3150 Almaden Expy Ste 223, San Jose, CA 95118-1253 | 2020-01-29 |
| 1477183705 | Benjamin C Jensen | Counselor | 1366 Petal Way, San Jose, CA 95129-4722 | 2020-01-26 |
| 1659910529 | Fred Finch Youth Center | Counselor | 2625 Zanker Rd Ste 122, San Jose, CA 95134-2130 | 2019-12-24 |
| Find all providers in SAN JOSE | ||||
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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.