person
Clyde Ellis Virges, CADCII09181953
Addiction (Substance Use Disorder) Counselor in San Jose, California
NPI 1134428162

Clyde Ellis Virges is an Addiction (Substance Use Disorder) Counselor based in San Jose, CA and is specialized in Addiction (Substance Use Disorder). Clyde Ellis Virges practices in San Jose, CA and has the professional credentials of CADCII09181953. The NPI Number for Clyde Ellis Virges is 1134428162 and holds a License No. E0312796 (California).

The current practice location address for Clyde Ellis Virges is 614 Tully Rd, San Jose, CA and can be reached out via phone at 408-977-1591 and via fax at 408-977-1136.

Location: 614 Tully Rd, San Jose, CA, 95111-1048
person
Provider Profile Details
NPI Number
1134428162
Provider Name
Clyde Ellis Virges
Credential
CADCII09181953
Provider Entity Type
Individual
Gender
Male
Address
614 Tully Rd, San Jose, CA, 95111-1048
Phone Number
408-977-1591
Fax Number
408-977-1136
Provider Enumeration Date
03/16/2011
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
614 Tully Rd
City
State
Zip
95111-1048
Phone Number
408-977-1591
Fax Number
408-977-1136
person
Provider Business Mailing Address Details
Address
614 Tully Rd
City
State
Zip
95111-1048
Phone Number
408-977-1591
Fax Number
408-977-1136
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
E0312796 (California)
Definition
Definition to come...
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