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Kenneth Mallon
Mental Health Counselor in San Jose, California
NPI 1205505302

Kenneth Mallon is a Mental Health Counselor based in San Jose, CA and is specialized in Mental Health. Kenneth Mallon practices in San Jose, CA. The NPI Number for Kenneth Mallon is 1205505302 and holds a License No. 116516 (California).

The current practice location address for Kenneth Mallon is 950 S Bascom Ave Ste 2005, San Jose, CA and can be reached out via phone at 650-487-0604.

Location: 950 S Bascom Ave Ste 2005, San Jose, CA, 95128-3535
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1205505302
Provider Name
Kenneth Mallon
Credential
Provider Entity Type
Individual
Gender
Male
Address
950 S Bascom Ave Ste 2005, San Jose, CA, 95128-3535
Phone Number
650-487-0604
Fax Number
Provider Enumeration Date
09/10/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
950 S Bascom Ave Ste 2005
City
San Jose
State
California
Zip
95128-3538
Phone Number
650-487-0604
Fax Number
person
Provider Business Mailing Address Details
Address
950 S Bascom Ave Ste 2005
City
San Jose
State
California
Zip
95128-3538
Phone Number
650-487-0604
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
116516 (California)
Definition
Definition to come...
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