Healthcare Provider Details

I. General information

NPI: 1497541668
Provider Name (Legal Business Name): ROOTED IN COMPASSION PSYCHOTHERAPY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2025
Last Update Date: 04/15/2025
Certification Date: 04/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4701 PATRICK HENRY DR STE 125
SANTA CLARA CA
95054-1889
US

IV. Provider business mailing address

4701 PATRICK HENRY DR STE 125
SANTA CLARA CA
95054-1889
US

V. Phone/Fax

Practice location:
  • Phone: 650-263-1442
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: NHU KHIET LY
Title or Position: MARRIAGE AND FAMILY THERAPIST
Credential: MFT
Phone: 650-263-1442