Provider Demographics
NPI:1770817058
Name:NGUYEN, THANHHUYEN THI (DC)
Entity Type:Individual
Prefix:DR
First Name:THANHHUYEN
Middle Name:THI
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 1:3322 E HAMMER LN
Mailing Address - Street 2:SUITE I
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95212-3843
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3322 E HAMMER LN
Practice Address - Street 2:SUITE I
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95212-3843
Practice Address - Country:US
Practice Address - Phone:408-726-2606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-20
Last Update Date:2009-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC31400111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor