Provider Demographics
NPI:1992144992
Name:NGUYEN, HANH THI (FNP)
Entity type:Individual
Prefix:MRS
First Name:HANH
Middle Name:THI
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MRS
Other - First Name:HANH
Other - Middle Name:THI
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:2118 CHISIN ST
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95121-3230
Mailing Address - Country:US
Mailing Address - Phone:408-910-4406
Mailing Address - Fax:408-238-2908
Practice Address - Street 1:10455 S DE ANZA BLVD
Practice Address - Street 2:
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014-3011
Practice Address - Country:US
Practice Address - Phone:408-996-1911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-24
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA778829363LF0000X, 163W00000X
CA95000107363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse