Provider Demographics
NPI:1710030184
Name:NGUYEN, JENNIFER UYEN (DC)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:UYEN
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11412 PALMWOOD DR
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92840-1622
Mailing Address - Country:US
Mailing Address - Phone:714-698-3880
Mailing Address - Fax:714-698-3886
Practice Address - Street 1:8887 WESTMINSTER AVE
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92844-2608
Practice Address - Country:US
Practice Address - Phone:714-698-3880
Practice Address - Fax:714-698-3886
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30175111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor