Basic Information
Provider Information
NPI: 1326052291
EntityType: 2
ReplacementNPI:  
OrganizationName: ASIAN AMERICANS FOR COMMUNITY INVOLVEMENT OF SANTA CLARA COUNTY
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: AACI BEHAVIORAL HEALTH
OtherOrganizationType: 5
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2400 MOORPARK AVE
Address2: SUITE 300
City: SAN JOSE
State: CA
PostalCode: 951282631
CountryCode: US
TelephoneNumber: 4089752730
FaxNumber:  
Practice Location
Address1: 2400 MOORPARK AVE
Address2: SUITE 300
City: SAN JOSE
State: CA
PostalCode: 951282631
CountryCode: US
TelephoneNumber: 4089752730
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/28/2006
LastUpdateDate: 08/14/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: KOHLI
AuthorizedOfficialFirstName: SARITA
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: PRESIDENT AND CEO
AuthorizedOfficialTelephone: 4089752730
IsSoleProprietor:  
IsOrganizationSubpart: Y
ParentOrganizationLBN: AACI
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: LMFT, MBA
NPICertificationDate: 08/14/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
251S00000X  Y AgenciesCommunity/Behavioral Health 

No ID Information.


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