Provider Demographics
NPI:1407642085
Name:NGUYEN, JENNY
Entity type:Individual
Prefix:
First Name:JENNY
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14342 BONNEMA ST
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-5101
Mailing Address - Country:US
Mailing Address - Phone:714-768-8271
Mailing Address - Fax:
Practice Address - Street 1:1075 E BETTERAVIA RD UNIT 201
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-7023
Practice Address - Country:US
Practice Address - Phone:805-621-7651
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-18
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program