Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XG0600X | Occupational Therapist - Gerontology | ||
Y | 225XP0200X | Occupational Therapist - Pediatrics |
NPI | 1861764516 |
---|---|
Provider Name | Kimberly Nguyen |
First Address | El Monte, CA 91732-1617 |
Second Address | Hacienda Heights, CA 91745-1500 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2012 |
Last Update Date | 26/01/2012 |