Healthcare Provider Details

I. General information

NPI: 1386120038
Provider Name (Legal Business Name): VIETNAMESE VOLUNTARY FOUNDATION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2018
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2072 LUCRETIA AVE
SAN JOSE CA
95122-3305
US

IV. Provider business mailing address

1765 LANDESS AVE STE 123
MILPITAS CA
95035-7019
US

V. Phone/Fax

Practice location:
  • Phone: 408-507-3192
  • Fax: 408-418-4068
Mailing address:
  • Phone: 408-507-3192
  • Fax: 408-418-4068

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name: BAO THUC TRIEU
Title or Position: PRESIDENT & CEO
Credential: CHW
Phone: 408-507-3192