=====================================================
General NPI Number Information
=====================================================
NPI Number | 1285067512
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | VCOC - ASIAN HEALTH CENTER
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/09/2013
-----------------------------------------------------
Last Update Date | 08/09/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9862 CHAPMAN AVE STE B
-----------------------------------------------------
City | GARDEN GROVE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92841-2726
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 714-640-3470
-----------------------------------------------------
Fax | 714-640-3475
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9862 CHAPMAN AVE STE B
-----------------------------------------------------
City | GARDEN GROVE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92841-2726
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 714-640-3470
-----------------------------------------------------
Fax | 714-640-3475
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | TRICIA NGUYEN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 714-640-3411
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 251B00000X
-----------------------------------------------------
Taxonomy Name | Case Management Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------