Provider Demographics
NPI:1588099204
Name:NGA THU NGUYEN
Entity type:Organization
Organization Name:NGA THU NGUYEN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:NGA
Authorized Official - Middle Name:THU
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:408-314-2255
Mailing Address - Street 1:1022 W HEDDING ST
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-1245
Mailing Address - Country:US
Mailing Address - Phone:408-314-2255
Mailing Address - Fax:408-248-9753
Practice Address - Street 1:1022 W HEDDING ST
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95126-1245
Practice Address - Country:US
Practice Address - Phone:408-314-2255
Practice Address - Fax:408-248-9753
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-12
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 279231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty