Provider Demographics
NPI:1205207305
Name:ANNIE H. NGUYEN PSYD LLC
Entity Type:Organization
Organization Name:ANNIE H. NGUYEN PSYD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNIE
Authorized Official - Middle Name:H
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:808-381-1838
Mailing Address - Street 1:PO BOX 640
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-0640
Mailing Address - Country:US
Mailing Address - Phone:808-381-1838
Mailing Address - Fax:808-261-8269
Practice Address - Street 1:40 AULIKE ST
Practice Address - Street 2:SUITE 411
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-2758
Practice Address - Country:US
Practice Address - Phone:808-381-1838
Practice Address - Fax:808-261-8269
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-14
Last Update Date:2015-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPSY 1365261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)