Healthcare Provider Details

I. General information

NPI: 1316338775
Provider Name (Legal Business Name): ASIAN AMERICANS FOR COMMUNITY INVOLVEMENT OF SANTA CLARA COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2015
Last Update Date: 08/14/2020
Certification Date: 08/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

749 STORY RD STE 50
SAN JOSE CA
95122-2600
US

IV. Provider business mailing address

2400 MOORPARK AVE STE 319
SAN JOSE CA
95128-2625
US

V. Phone/Fax

Practice location:
  • Phone: 669-800-6991
  • Fax:
Mailing address:
  • Phone: 408-975-2730
  • Fax: 408-975-2745

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SARITA KOHLI
Title or Position: CEO AND PRESIDENT
Credential: LMFT, MBA
Phone: 408-975-2730