Provider Demographics
NPI:1952879348
Name:VU, VICTORIA THI (OTR/L)
Entity Type:Individual
Prefix:
First Name:VICTORIA THI
Middle Name:
Last Name:VU
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:
Other - Last Name:VU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTR/L
Mailing Address - Street 1:911 BERN CT
Mailing Address - Street 2:STE 140
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95112-1242
Mailing Address - Country:US
Mailing Address - Phone:408-573-7720
Mailing Address - Fax:844-789-4011
Practice Address - Street 1:911 BERN CT
Practice Address - Street 2:STE 140
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95112-1242
Practice Address - Country:US
Practice Address - Phone:408-573-7720
Practice Address - Fax:844-789-4011
Is Sole Proprietor?:No
Enumeration Date:2018-11-05
Last Update Date:2022-07-28
Deactivation Date:2019-07-18
Deactivation Code:
Reactivation Date:2022-07-28
Provider Licenses
StateLicense IDTaxonomies
CA23774225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist