Provider Demographics
NPI:1780208553
Name:NGO, AI-NHAT (LCSW)
Entity Type:Individual
Prefix:
First Name:AI-NHAT
Middle Name:
Last Name:NGO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9360 ACTIVITY RD STE B
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92126-4410
Mailing Address - Country:US
Mailing Address - Phone:619-764-3431
Mailing Address - Fax:
Practice Address - Street 1:9360 ACTIVITY RD STE B
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92126-4410
Practice Address - Country:US
Practice Address - Phone:619-764-3431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-07
Last Update Date:2020-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical