Basic Information
Provider Information
NPI: 1033342423
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: VO
FirstName: MY LINH
MiddleName: THI
NamePrefix: DR.
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2400 MOORPARK AVE STE 300
Address2:  
City: SAN JOSE
State: CA
PostalCode: 951282680
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 2400 MOORPARK AVE STE 300
Address2:  
City: SAN JOSE
State: CA
PostalCode: 951282680
CountryCode: US
TelephoneNumber: 4089752730
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/01/2009
LastUpdateDate: 09/14/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/14/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X  N Behavioral Health & Social Service ProvidersCounselorMental Health
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
103T00000XPSY29712CAY Behavioral Health & Social Service ProvidersPsychologist 

No ID Information.


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