Provider Demographics
NPI:1578755997
Name:LE, PHUOC
Entity Type:Individual
Prefix:MR
First Name:PHUOC
Middle Name:
Last Name:LE
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:SAM
Other - Middle Name:
Other - Last Name:LE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5330 POWER INN RD STE A
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95820-6757
Mailing Address - Country:US
Mailing Address - Phone:916-383-6784
Mailing Address - Fax:916-383-8488
Practice Address - Street 1:5330 POWER INN RD STE A
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95820-6757
Practice Address - Country:US
Practice Address - Phone:916-383-6784
Practice Address - Fax:916-383-8488
Is Sole Proprietor?:No
Enumeration Date:2007-08-10
Last Update Date:2007-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor