MEDICARE: VIETNAMESE VOLUNTARY FOUNDATION, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	172V00000X	Community Health Worker
2	104100000X	Social Worker		CA

General Provider Information

NPI Number	:	1386120038
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VIETNAMESE VOLUNTARY FOUNDATION, INC.

Provider Business Mailing Address
First Line	:	1765 LANDESS AVE STE 123
Second Line	:
City	:	MILPITAS
State	:	CA
Zip	:	95035-7019
Country	:	US
Telephone Number	:	408-507-3192
Fax Number	:	408-418-4068

Provider Business Practice Location Address
First Line	:	2072 LUCRETIA AVE
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95122-3305
Country	:	US
Telephone Number	:	408-507-3192
Fax Number	:	408-418-4068

Authorized Official
Title or Position	:	PRESIDENT & CEO
Name	:	BAO THUC TRIEU
Credential	:	CHW
Telephone Number	:	408-507-3192

Provider Enumeration Date	:	07/16/2018
Last Update Date	:	06/12/2026

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Directions to “VIETNAMESE VOLUNTARY FOUNDATION, INC. ” Practice Location

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