Provider Demographics
NPI:1033373253
Name:NGUYEN, KATIE (LVN)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:LOI
Other - Middle Name:THI
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7750 10TH ST APT 4
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-5332
Mailing Address - Country:US
Mailing Address - Phone:714-468-6253
Mailing Address - Fax:
Practice Address - Street 1:13950 MILTON ST. # 303
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683
Practice Address - Country:US
Practice Address - Phone:714-901-4629
Practice Address - Fax:714-901-4639
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-16
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN 234879164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse