Provider Demographics
NPI:1437856101
Name:NGUYEN, JENNY P
Entity type:Individual
Prefix:
First Name:JENNY
Middle Name:P
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9136 W YUKON DR
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85382-5227
Mailing Address - Country:US
Mailing Address - Phone:480-864-0362
Mailing Address - Fax:
Practice Address - Street 1:9136 W YUKON DR
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85382-5227
Practice Address - Country:US
Practice Address - Phone:480-864-0362
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-13
Last Update Date:2025-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician