| Mekong Community Center | |
|
2203 Tully Rd San Jose CA 95122-1348 | |
| (408) 937-1553 | |
| Not Available |
| Full Name | Mekong Community Center |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 2203 Tully Rd, San Jose, California |
| Authorized Official Name and Position | Lana N Nguyen (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 4089142894 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mekong Community Center 2203 Tully Rd San Jose CA 95122-1348 Ph: (408) 937-1553 | Mekong Community Center 2203 Tully Rd San Jose CA 95122-1348 Ph: (408) 937-1553 |
| NPI Number | 1104300011 |
|---|---|
| Provider Enumeration Date | 09/18/2018 |
| Last Update Date | 09/18/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104300011 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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