Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 16543 | CA |
NPI | 1871115428 |
---|---|
Provider Name | Huong Nguyen |
First Address | San Diego, CA 92126-4872 |
Second Address | San Diego, CA 92105-5424 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2020 |
Last Update Date | 16/05/2020 |