Provider Demographics
NPI:1326863564
Name:NGUYEN, ELEANOR LUZANO (PHN, RN)
Entity type:Individual
Prefix:MS
First Name:ELEANOR
Middle Name:LUZANO
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:PHN, RN
Other - Prefix:
Other - First Name:LYNN
Other - Middle Name:LUZANO
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1111 JACKSON ST FL 6
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94607-4813
Mailing Address - Country:US
Mailing Address - Phone:510-265-8208
Mailing Address - Fax:510-780-8810
Practice Address - Street 1:6694 PALOVERDE RD
Practice Address - Street 2:
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94552-9651
Practice Address - Country:US
Practice Address - Phone:510-265-8208
Practice Address - Fax:510-780-8810
Is Sole Proprietor?:No
Enumeration Date:2024-11-21
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9503577163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse