Provider Demographics
NPI:1073086385
Name:NGUYEN, ANH-THU (LAC, DIPL OM)
Entity Type:Individual
Prefix:DR
First Name:ANH-THU
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:LAC, DIPL OM
Other - Prefix:DR
Other - First Name:ANH
Other - Middle Name:T
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LAC, DIPL OM
Mailing Address - Street 1:PO BOX 2660
Mailing Address - Street 2:
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94017-2660
Mailing Address - Country:US
Mailing Address - Phone:408-690-0151
Mailing Address - Fax:
Practice Address - Street 1:595 LAWRENCE EXPY
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94085-3922
Practice Address - Country:US
Practice Address - Phone:408-690-0151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-09
Last Update Date:2019-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18357171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist