Provider Demographics
NPI:1154849842
Name:KIEU, VY (NP)
Entity Type:Individual
Prefix:
First Name:VY
Middle Name:
Last Name:KIEU
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4755 KATELLA AVE., SUITE 102
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:CA
Mailing Address - Zip Code:90720
Mailing Address - Country:US
Mailing Address - Phone:657-241-8101
Mailing Address - Fax:657-276-4730
Practice Address - Street 1:4755 KATELLA AVE., SUITE 102
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:CA
Practice Address - Zip Code:90720
Practice Address - Country:US
Practice Address - Phone:657-241-8101
Practice Address - Fax:657-276-4730
Is Sole Proprietor?:No
Enumeration Date:2017-09-02
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95005410363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care