Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | 0-16-7129 | CO |
NPI | 1043761430 |
---|---|
Provider Name | Viet Anh Nguyen |
First Address | Santa Ana, CA 92706-1238 |
Second Address | Costa Mesa, CA 92626-1517 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2016 |
Last Update Date | 20/10/2016 |