Provider Demographics
NPI:1497284418
Name:NGUYEN, THY HUYEN (MA)
Entity Type:Individual
Prefix:MS
First Name:THY
Middle Name:HUYEN
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10369 MILLS TOWER DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-5444
Mailing Address - Country:US
Mailing Address - Phone:209-337-8955
Mailing Address - Fax:
Practice Address - Street 1:900 FULTON AVE STE 205
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-4517
Practice Address - Country:US
Practice Address - Phone:916-484-3570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-05
Last Update Date:2019-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF97384106H00000X
CALMFT116465106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist