Provider Demographics
NPI:1568800126
Name:NGUYEN, MENGTING SHIEH (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MENGTING
Middle Name:SHIEH
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2756 EDISON ST
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94403-2458
Mailing Address - Country:US
Mailing Address - Phone:415-533-7882
Mailing Address - Fax:
Practice Address - Street 1:2756 EDISON ST
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94403-2458
Practice Address - Country:US
Practice Address - Phone:415-533-7882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-05
Last Update Date:2015-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14545235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist