Provider Demographics
NPI:1285136168
Name:NGUYEN, RYAN TUAN-KHANH (LMFT)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:TUAN-KHANH
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:RYAN
Other - Middle Name:TUANKHANH
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AMFT
Mailing Address - Street 1:781 ANACAPA CT
Mailing Address - Street 2:
Mailing Address - City:MILPITAS
Mailing Address - State:CA
Mailing Address - Zip Code:95035-4548
Mailing Address - Country:US
Mailing Address - Phone:408-398-6638
Mailing Address - Fax:
Practice Address - Street 1:950 W JULIAN ST
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95126-2719
Practice Address - Country:US
Practice Address - Phone:408-292-9353
Practice Address - Fax:408-287-3104
Is Sole Proprietor?:No
Enumeration Date:2018-03-06
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
CA120290106H00000X
CA145670106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst