MEDICARE: ASIAN AMERICANS FOR COMMUNITY INVOLVEMENT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1104959600
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASIAN AMERICANS FOR COMMUNITY INVOLVEMENT

Provider Business Mailing Address
First Line	:	2400 MOORPARK AVE
Second Line	:	SUITE 300
City	:	SAN JOSE
State	:	CA
Zip	:	95128-2631
Country	:	US
Telephone Number	:	408-975-2730
Fax Number	:	408-975-2745

Provider Business Practice Location Address
First Line	:	749 STORY RD
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95122-2600
Country	:	US
Telephone Number	:	408-975-2730
Fax Number	:	408-975-2745

Authorized Official
Title or Position	:	PRESIDENT & CEO
Name	:	SARITA KOHLI
Credential	:	LMFT, MBA
Telephone Number	:	408-975-2730

Provider Enumeration Date	:	03/13/2007
Last Update Date	:	07/21/2022

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