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Mr. Herbert Alexander Tom IV
Mental Illness Community Based Residential Treatment Facility in San Mateo, California
NPI 1386378107

Herbert Alexander Tom IV is a Mental Illness Community Based Residential Treatment Facility based in San Jose, CA. Herbert Alexander Tom IV practices in San Mateo, CA. The NPI Number for Herbert Alexander Tom IV is 1386378107 and holds a License No. (California).

The current practice location address for Herbert Alexander Tom IV is 2600 S El Camino Real Ste 200, San Mateo, CA and can be reached out via phone at 650-372-4080. You can also correspond with Herbert Alexander Tom IV through the mailing address at 1922 THE ALAMEDA STE 316, SAN JOSE, CA - 95126-1461 (mailing address contact number: ).

Location: 2600 S El Camino Real Ste 200, San Mateo, CA, 95126-1461
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1386378107
Provider Name
Herbert Alexander Tom IV
Credential
Provider Entity Type
Individual
Gender
Male
Address
2600 S El Camino Real Ste 200, San Mateo, CA, 95126-1461
Phone Number
650-372-4080
Fax Number
Provider Enumeration Date
07/16/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
2600 S El Camino Real Ste 200
City
San Mateo
State
California
Zip
94403-2382
Phone Number
650-372-4080
Fax Number
person
Provider Business Mailing Address Details
Address
2600 S El Camino Real Ste 200
City
San Mateo
State
California
Zip
94403-2382
Phone Number
650-372-4080
Fax Number
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Mental Illness
Speciality
-
Taxonomy
320800000X
License No.
()
Definition
A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
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