Provider Demographics
NPI:1154049112
Name:LE, UYEN (NBC-HWC)
Entity type:Individual
Prefix:
First Name:UYEN
Middle Name:
Last Name:LE
Suffix:
Gender:F
Credentials:NBC-HWC
Other - Prefix:
Other - First Name:JENNIE
Other - Middle Name:
Other - Last Name:LE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:600 W SANTA ANA BLVD STE 114
Mailing Address - Street 2:PMB 3113
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92701-4514
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4313 SILVER DR
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92703-2620
Practice Address - Country:US
Practice Address - Phone:714-360-8602
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-16
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
A-3500343171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach