Provider Demographics
NPI:1316370265
Name:NGUYEN, CHRISTAN LAM (MA)
Entity Type:Individual
Prefix:MR
First Name:CHRISTAN
Middle Name:LAM
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 S HARBOR BLVD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92704-6418
Mailing Address - Country:US
Mailing Address - Phone:562-431-5100
Mailing Address - Fax:562-431-3560
Practice Address - Street 1:2900 S HARBOR BLVD
Practice Address - Street 2:SUITE 220
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92704-6418
Practice Address - Country:US
Practice Address - Phone:562-431-5100
Practice Address - Fax:562-431-3560
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-14
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA108067106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist