Provider Demographics
NPI:1114176781
Name:NGUYEN, MICHELLE MAI (LCSW)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:MAI
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7916 ARTESIA BLVD
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90621-2421
Mailing Address - Country:US
Mailing Address - Phone:714-468-7857
Mailing Address - Fax:
Practice Address - Street 1:200 W SANTA ANA BLVD
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92701-4134
Practice Address - Country:US
Practice Address - Phone:855-422-1421
Practice Address - Fax:714-834-4303
Is Sole Proprietor?:No
Enumeration Date:2008-09-18
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker