Organization · Type 2 NPI

Disruptive Therapy Collective for the Individual, Family, and Child

Mental Health Clinic/Center (Including Community Mental Health Center) · San Jose, CA

NPI number 1083392302 Active

Practice location

1769 Park Ave Ste 250
San Jose, CA 95126-2030

Specialties and licenses

Taxonomy	Code	License
Mental Health Clinic/Center (Including Community Mental Health Center) Primary	261QM0801X	None listed

Mental Health Clinic/Center (Including Community Mental Health Center): Definition to come...

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NPI record

NPI: 1083392302
Entity type: Organization (Type 2)
Issued: Jul 6, 2023
Last updated: Mar 6, 2026
Status: Active

Other names

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Disruptive Therapy Collective · doing business as
Disruptive Therapy Collective · doing business as

Authorized official

Alice Bui, LMFT
CEO
(408) 365-4238

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About NPI 1083392302

Disruptive Therapy Collective for the Individual, Family, and Child's National Provider Identifier is 1083392302, issued on Jul 6, 2023. The primary taxonomy on file is Mental Health Clinic/Center (Including Community Mental Health Center) (261QM0801X), and the practice location is in San Jose, CA. The record was last updated on Mar 6, 2026.