2nd row on the left is "Republic of Vietnam Campaign Medal", I'm pretty sure (photo's at a slight angle)...
I see 11 ribbons on his chest. We've got PH, Bronze Star, Silver Star, and National Defense. What are the other 7? I doubt his unit got that many Presidential Unit Citations.
Almost impossible to say for sure but he should have had two ribbons junior to the National Defense Service Ribbon. Those would be the Vietnam Service Ribbon and, most junior, the Republic of Vietnam Campaign Ribbon.
Senior to National Defense, he would certainly have a Combat Action ribbon and, most likely, a Navy Meritorious Unit Commendation in addition to the ones you mention. (I don't believe that there are medals corresponding to the Combat Action, Unit Commendation and the Vietnam Service ribbons.)