Provider Demographics
NPI:1750490363
Name:ASIAN AMERICANS FOR COMMUNITY INVOLVEMENT OF SANTA CLARA COUNTY
Entity Type:Organization
Organization Name:ASIAN AMERICANS FOR COMMUNITY INVOLVEMENT OF SANTA CLARA COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:SARITA
Authorized Official - Middle Name:
Authorized Official - Last Name:KOHLI
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT, MBA
Authorized Official - Phone:408-975-2730
Mailing Address - Street 1:2400 MOORPARK AVE
Mailing Address - Street 2:SUITE 319
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128
Mailing Address - Country:US
Mailing Address - Phone:408-975-2763
Mailing Address - Fax:408-975-2764
Practice Address - Street 1:2400 MOORPARK AVE
Practice Address - Street 2:SUITE 319
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128
Practice Address - Country:US
Practice Address - Phone:408-975-2763
Practice Address - Fax:408-975-2764
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ASIAN AMERICANS FOR COMMUNITY INVOLVEMENT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-29
Last Update Date:2020-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFHC70850FMedicaid
CABCP70850FOtherMEDICAID BCP PROGRAM
CAEAP70850FOtherMEDICAID EAPC PROGRAM
CAFHC70850FMedicaid
CABCP70850FOtherMEDICAID BCP PROGRAM