Provider Demographics
NPI:1144658774
Name:VILMS, DINAZ
Entity type:Individual
Prefix:
First Name:DINAZ
Middle Name:
Last Name:VILMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 ALEXIAN DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95116-1901
Mailing Address - Country:US
Mailing Address - Phone:408-272-6586
Mailing Address - Fax:408-272-6569
Practice Address - Street 1:2101 ALEXIAN DR
Practice Address - Street 2:SUITE 110
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-1901
Practice Address - Country:US
Practice Address - Phone:408-272-6586
Practice Address - Fax:408-272-6569
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-16
Last Update Date:2013-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW 287351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical