Provider Demographics
NPI:1003141300
Name:NGO, PHUONG (MSW INTERN)
Entity Type:Individual
Prefix:MS
First Name:PHUONG
Middle Name:
Last Name:NGO
Suffix:
Gender:F
Credentials:MSW INTERN
Other - Prefix:MS
Other - First Name:SERENA
Other - Middle Name:
Other - Last Name:NGO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1975 LONG BEACH BLVD FL 2
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90806-5501
Mailing Address - Country:US
Mailing Address - Phone:562-599-9401
Mailing Address - Fax:
Practice Address - Street 1:1975 LONG BEACH BLVD FL 2
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-5501
Practice Address - Country:US
Practice Address - Phone:562-599-9401
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-05
Last Update Date:2009-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health