Basic Information
Provider Information
NPI: 1245374909
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RISHEL
FirstName: WILLIAM
MiddleName: SHERMAN
NamePrefix: MR.
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2001 THE ALSMEDA
Address2: ALLIANCE FOR COMMUNITY CARE
City: SAN JOSE
State: CA
PostalCode: 951261136
CountryCode: US
TelephoneNumber: 4082617777
FaxNumber: 4082549960
Practice Location
Address1: LA SELVA 652 FOREST AVE
Address2:  
City: PALO ALTO
State: CA
PostalCode: 943012622
CountryCode: US
TelephoneNumber: 6503231401
FaxNumber: 6503231720
Other Information
ProviderEnumerationDate: 02/16/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
171M00000X  Y Other Service ProvidersCase Manager/Care Coordinator 

No ID Information.


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