Provider Demographics
NPI:1104339522
Name:LE, ANH NGOC (ND, LAC, LMP)
Entity type:Individual
Prefix:MRS
First Name:ANH
Middle Name:NGOC
Last Name:LE
Suffix:
Gender:F
Credentials:ND, LAC, LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2530 J ST STE 100
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-4849
Mailing Address - Country:US
Mailing Address - Phone:916-446-2591
Mailing Address - Fax:
Practice Address - Street 1:2530 J ST STE 100
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-4849
Practice Address - Country:US
Practice Address - Phone:916-446-2591
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-07
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT60843141175F00000X
CAND1329175F00000X
WAMA60504707225700000X
CA172V00000X
WAAC60805280171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No175F00000XOther Service ProvidersNaturopath
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No171100000XOther Service ProvidersAcupuncturist