Basic Information
| Provider Information | |||||||||
| NPI: | 1497034417 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ROMERO | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | ANTHONY | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | II | ||||||||
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| Mailing Information | |||||||||
| Address1: | 160 E VIRGINIA ST | ||||||||
| Address2: | SUITE 280 | ||||||||
| City: | SAN JOSE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 951125857 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4082876200 | ||||||||
| FaxNumber: | 4089981535 | ||||||||
| Practice Location | |||||||||
| Address1: | 160 E VIRGINIA ST | ||||||||
| Address2: | SUITE 280 | ||||||||
| City: | SAN JOSE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 951125857 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4082876200 | ||||||||
| FaxNumber: | 4089981535 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/08/2011 | ||||||||
| LastUpdateDate: | 08/08/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | CA | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.