Provider Demographics
NPI:1285413229
Name:NGUYEN, THAO HUONG
Entity type:Individual
Prefix:
First Name:THAO
Middle Name:HUONG
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 CORPORATE PARK # 303-304
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92606-5131
Mailing Address - Country:US
Mailing Address - Phone:949-857-6051
Mailing Address - Fax:
Practice Address - Street 1:30 CORPORATE PARK # 303-304
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92606-5131
Practice Address - Country:US
Practice Address - Phone:949-857-6051
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-28
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18241235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist