Provider Demographics
NPI:1134095037
Name:VICTOR COMMUNITY SUPPORT SERVICES
Entity type:Organization
Organization Name:VICTOR COMMUNITY SUPPORT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JASLEEN
Authorized Official - Middle Name:KAUR
Authorized Official - Last Name:TOMM
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:530-635-2204
Mailing Address - Street 1:1520 EUREKA RD STE 102
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-2849
Mailing Address - Country:US
Mailing Address - Phone:916-751-0154
Mailing Address - Fax:
Practice Address - Street 1:1520 EUREKA RD STE 102
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-2849
Practice Address - Country:US
Practice Address - Phone:916-751-0154
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-16
Last Update Date:2025-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)