NPIMap

Organization Active NPI

Victor Community Support Services, Inc.

  • Community/Behavioral Health Agency
  • San Jose, CA
National Provider Identifier
1962392704
Registry record updated Aug 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
VICTOR COMMUNITY SUPPORT SERVICES, INC.
Practice address
97 E Brokaw Rd Ste 150
San Jose, CA 95112-4221
Phone
(408) 726-1849
Fax
(530) 230-1264
NPI assigned
Jul 3, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Angie R Wiechert
Title
Director of Financial Analysis
Phone
(530) 230-1210

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

97 E Brokaw Rd Ste 150
San Jose, CA 95112-4221

Mailing address

1360 E Lassen Ave
Chico, CA 95973-7823
Phone (530) 893-0758

Other identifiers 1

IdentifierTypeStateIssuer
01042OtherCALEGAL ENTITY NUMBER

Other names 1

  • Victor Community Support Services, San Jose Other name

National Provider Directory

National Provider Directory
Tax ID family
Victor Community Support Services Inc34 organizations share this tax ID, including this one

Other organizations with this tax ID 33

Organizations that report the same tax identification number in the National Provider Directory.

View all 33

Locations

97 E Brokaw Rd
Ste 150
San Jose, CA 95112
Phone (408) 726-1849

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1751500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755734400000",
    "number": "1962392704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1360 E LASSEN AVE",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959737823",
            "telephone_number": "530-893-0758",
            "fax_number": "530-893-0502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "97 E BROKAW RD STE 150",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951124221",
            "telephone_number": "408-726-1849",
            "fax_number": "530-230-1264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTOR COMMUNITY SUPPORT SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-03",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-21",
        "status": "A",
        "authorized_official_last_name": "WIECHERT",
        "authorized_official_first_name": "ANGIE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCIAL ANALYSIS",
        "authorized_official_telephone_number": "530-230-1210"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LEGAL ENTITY NUMBER",
            "identifier": "01042",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Victor Community Support Services, San Jose",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Victor Community Support Services, San Jose",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.