Healthcare Provider Details
I. General information
NPI: 1124815394
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: 04/22/2025
Last Update Date: 11/17/2025
Certification Date: 11/17/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
266 N JACKSON AVE STE 4
SAN JOSE CA
95116-1606
US
IV. Provider business mailing address
2400 MOORPARK AVE STE 300
SAN JOSE CA
95128-2680
US
V. Phone/Fax
- Phone: 408-975-2763
- Fax:
- Phone: 408-975-2730
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0801X |
| Taxonomy | Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SARITA
U
KOHLI
Title or Position: AO
Credential:
Phone: 408-975-2730