Provider Demographics
NPI:1093403693
Name:NGUYEN, JASMINE H
Entity Type:Individual
Prefix:MRS
First Name:JASMINE
Middle Name:H
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 W. TOWN & COUNTRY RD,
Mailing Address - Street 2:SUITE 1250
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868
Mailing Address - Country:US
Mailing Address - Phone:949-357-2556
Mailing Address - Fax:855-568-2494
Practice Address - Street 1:1100 W. TOWN & COUNTRY RD.
Practice Address - Street 2:SUIT 1250
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868
Practice Address - Country:US
Practice Address - Phone:949-357-2566
Practice Address - Fax:855-568-2494
Is Sole Proprietor?:No
Enumeration Date:2023-05-01
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician