Basic Information
Provider Information
NPI: 1285050484
EntityType: 2
ReplacementNPI:  
OrganizationName: ASIAN AMERICANS FOR COMMUNITY INVOLVEMENT OF SANTA CLARA COUNTY
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Mailing Information
Address1: 2400 MOORPARK AVE
Address2: SUITE 300
City: SAN JOSE
State: CA
PostalCode: 951282631
CountryCode: US
TelephoneNumber: 4089752730
FaxNumber: 4089752745
Practice Location
Address1: 749 STORY RD
Address2: STE 50
City: SAN JOSE
State: CA
PostalCode: 95122
CountryCode: US
TelephoneNumber: 4089752730
FaxNumber: 4089752745
Other Information
ProviderEnumerationDate: 03/12/2014
LastUpdateDate: 08/14/2020
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: LEW
AuthorizedOfficialFirstName: MICHELE
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: PRESIDENT AND CEO
AuthorizedOfficialTelephone: 4089752730
IsSoleProprietor:  
IsOrganizationSubpart: N
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NPICertificationDate: 08/14/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
251S00000X  Y AgenciesCommunity/Behavioral Health 

No ID Information.


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