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Eva Black
Student in an Organized Health Care Education/Training Program in San Jose, California
NPI 1093256174

Eva Black is a Student in an Organized Health Care Education/Training Program based in San Jose, CA. Eva Black practices in San Jose, CA. The NPI Number for Eva Black is 1093256174 and holds a License No. (California).

The current practice location address for Eva Black is 1555 Parkmoor Ave, San Jose, CA and can be reached out via phone at 408-822-0402.

Location: 1555 Parkmoor Ave, San Jose, CA, 95128-2407
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1093256174
Provider Name
Eva Black
Credential
Provider Entity Type
Individual
Gender
Female
Address
1555 Parkmoor Ave, San Jose, CA, 95128-2407
Phone Number
408-822-0402
Fax Number
Provider Enumeration Date
03/09/2017
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
110026265E 05 MA
institution
Provider Business Practice Location Address Details
Address
1555 Parkmoor Ave
City
San Jose
State
California
Zip
95128-2407
Phone Number
408-822-0402
Fax Number
person
Provider Business Mailing Address Details
Address
1555 Parkmoor Ave
City
San Jose
State
California
Zip
95128-2407
Phone Number
408-822-0402
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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