Provider Demographics
NPI:1306389440
Name:NGUYEN, NHI PHAM (BCBA)
Entity Type:Individual
Prefix:
First Name:NHI
Middle Name:PHAM
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17732 BEACH BLVD., SUITE G
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-7807
Mailing Address - Country:US
Mailing Address - Phone:714-655-7142
Mailing Address - Fax:
Practice Address - Street 1:17732 BEACH BLVD., SUITE G
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647
Practice Address - Country:US
Practice Address - Phone:714-655-7142
Practice Address - Fax:833-224-5825
Is Sole Proprietor?:No
Enumeration Date:2016-11-21
Last Update Date:2019-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-15-19111103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst