Provider Demographics
NPI:1528762515
Name:NGUYEN, ANDREW TIEN
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:TIEN
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 HEGENBERGER RD STE 230
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94621-1447
Mailing Address - Country:US
Mailing Address - Phone:510-542-1321
Mailing Address - Fax:
Practice Address - Street 1:100 HEGENBERGER RD STE 230
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94621-1447
Practice Address - Country:US
Practice Address - Phone:510-542-1321
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-27
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator