Provider Demographics
NPI:1447574207
Name:DO, TAM THI
Entity Type:Individual
Prefix:MS
First Name:TAM
Middle Name:THI
Last Name:DO
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:XUAN TAM
Other - Middle Name:THI
Other - Last Name:DO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1979 S KING RD
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95122-2231
Mailing Address - Country:US
Mailing Address - Phone:408-646-7372
Mailing Address - Fax:
Practice Address - Street 1:2400 MOORPARK AVE STE 300
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-2680
Practice Address - Country:US
Practice Address - Phone:408-975-2730
Practice Address - Fax:408-975-2745
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-23
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 171M00000X
CA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program