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Organization
VICTOR COMMUNITY SUPPORT SERVICES, INC.
Active
Organization
VICTOR COMMUNITY SUPPORT SERVICES, INC.
Active
Other names
Victor Community Support Services, San Jose
Organization subpart
No
Provider details
NPI number
Authorized official
ANGIE R WIECHERT (DIRECTOR OF FINANCIAL ANALYSIS)
(530) 230-1210
Entity
Organization
Contact information
Practice address
97 E BROKAW RD STE 150, SAN JOSE, CA 95112-4221
(408) 726-1849
(530) 230-1264
Mailing address
1360 E LASSEN AVE, CHICO, CA 95973-7823
(530) 893-0758
(530) 893-0502
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01042
LEGAL ENTITY NUMBER
CA
Enumeration date
07/03/2025
Last updated
08/21/2025
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