Healthcare Provider Details

I. General information

NPI: 1154656155
Provider Name (Legal Business Name): ASIAN AMERICNAS FOR COMMUNITY INVOLVEMENT OF SANTA CLARA COUNTY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2009
Last Update Date: 10/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 SENTER RD
SAN JOSE CA
95111-1332
US

IV. Provider business mailing address

2400 MOORPARK AVE SUITE 308
SAN JOSE CA
95128-2631
US

V. Phone/Fax

Practice location:
  • Phone: 408-347-4152
  • Fax: 408-347-4155
Mailing address:
  • Phone: 408-975-2730
  • Fax: 408-975-2745

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number430042
License Number StateCA

VIII. Authorized Official

Name: MRS. MICHELE LEW
Title or Position: PRESIDENT AND C.E.O.
Credential:
Phone: 408-975-2730