Provider Demographics
NPI:1902778012
Name:NGUYEN, ANN KIM (RN)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:KIM
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:956 AZALEA DR
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-1795
Mailing Address - Country:US
Mailing Address - Phone:714-336-1053
Mailing Address - Fax:
Practice Address - Street 1:956 AZALEA DR
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-1795
Practice Address - Country:US
Practice Address - Phone:714-336-1053
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-18
Last Update Date:2025-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95086847163WA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)