Provider Demographics
NPI:1679275986
Name:NGUYEN, ANDY HOA
Entity Type:Individual
Prefix:
First Name:ANDY
Middle Name:HOA
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2265 W GOLDEN WEST AVE # 2
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92804-6427
Mailing Address - Country:US
Mailing Address - Phone:310-218-8286
Mailing Address - Fax:
Practice Address - Street 1:2265 W GOLDEN WEST AVE # 2
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92804-6427
Practice Address - Country:US
Practice Address - Phone:310-218-8286
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician