Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | ND1179 | CA |
NPI | 1053912337 |
---|---|
Provider Name | Kieu Mindy Nguyen |
First Address | Oakland, CA 94609-2695 |
Second Address | Oakland, CA 94609-2695 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/11/2020 |
Last Update Date | 04/11/2020 |