Provider Demographics
NPI:1811267016
Name:VU, LONG THIEN
Entity type:Individual
Prefix:MR
First Name:LONG
Middle Name:THIEN
Last Name:VU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2670 S WHITE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95148-2073
Mailing Address - Country:US
Mailing Address - Phone:408-937-1553
Mailing Address - Fax:408-516-0053
Practice Address - Street 1:2670 S WHITE RD STE 200
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95148-2073
Practice Address - Country:US
Practice Address - Phone:408-937-1553
Practice Address - Fax:408-516-0053
Is Sole Proprietor?:No
Enumeration Date:2012-01-04
Last Update Date:2023-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA928821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical