Provider Demographics
NPI:1225224744
Name:NGUYEN, CLAIRE MINH (PA-C, LAC)
Entity Type:Individual
Prefix:MS
First Name:CLAIRE
Middle Name:MINH
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:PA-C, LAC
Other - Prefix:
Other - First Name:CLAIRE
Other - Middle Name:MINH
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PA-C, LAC
Mailing Address - Street 1:1500 21ST ST
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95811-5216
Mailing Address - Country:US
Mailing Address - Phone:916-443-3299
Mailing Address - Fax:916-325-1984
Practice Address - Street 1:1500 21ST ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95811
Practice Address - Country:US
Practice Address - Phone:916-443-3299
Practice Address - Fax:916-325-1984
Is Sole Proprietor?:No
Enumeration Date:2007-09-18
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC11633171100000X
CAPA52280363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No171100000XOther Service ProvidersAcupuncturist