Provider Demographics
NPI:1669010021
Name:NGUYEN, NICHOLAS HOANG (FNP-C)
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:HOANG
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50100 GOLSH RD
Mailing Address - Street 2:
Mailing Address - City:VALLEY CENTER
Mailing Address - State:CA
Mailing Address - Zip Code:92082-5338
Mailing Address - Country:US
Mailing Address - Phone:760-749-1410
Mailing Address - Fax:
Practice Address - Street 1:INDIAN HEALTH COUNCIL
Practice Address - Street 2:50100
Practice Address - City:VALLEY CENTER
Practice Address - State:CA
Practice Address - Zip Code:92082-9208
Practice Address - Country:US
Practice Address - Phone:749-141-0760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-17
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95013522363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily