Provider Demographics
NPI:1144572009
Name:BUI, ANNIE NGUYEN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ANNIE
Middle Name:NGUYEN
Last Name:BUI
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13894 BROOKHURST ST
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92843-3173
Mailing Address - Country:US
Mailing Address - Phone:626-246-8678
Mailing Address - Fax:
Practice Address - Street 1:1634 W 19TH ST # C
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92706-2301
Practice Address - Country:US
Practice Address - Phone:714-479-0102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-02
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29647103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical