Provider Demographics
NPI:1730536640
Name:BANGURA, YUSUF
Entity type:Individual
Prefix:
First Name:YUSUF
Middle Name:
Last Name:BANGURA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:359 UNION AVE
Mailing Address - Street 2:APT.B
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95008-4237
Mailing Address - Country:US
Mailing Address - Phone:408-571-9124
Mailing Address - Fax:
Practice Address - Street 1:59 CROCKER CT
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95111-4301
Practice Address - Country:US
Practice Address - Phone:408-227-8660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-20
Last Update Date:2016-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor