Mongillo, Matthew Lawrence

Mongillo, Matthew Lawrence is an individual health care provider with primary practice located at 232 E Gish Rd , San Jose CA 95112-4706. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Other Service Providers / Community Health Worker, Other Service Providers / Case Manager/Care Coordinator. Other Service Providers / Case Manager/Care Coordinator is his primary health care specialty. Mongillo, Matthew Lawrence can be contacted via phone (669) 221-0148.

Contact Information

Primary practice address
232 E Gish Rd San Jose CA 95112-4706
Phone: (669) 221-0148
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Other Service Providers / Community Health Worker 172V00000X
Other Service Providers / Case Manager/Care Coordinator 171M00000X

Profile Details

NPI number 1609949734
LBN Legal business name Mongillo, Matthew Lawrence
Credentials BA, AA, MHRS, RE
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 16th, 2006
Last updated May 24th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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