Provider Demographics
NPI:1013789544
Name:NGHIEM, THUY VU
Entity type:Individual
Prefix:MS
First Name:THUY
Middle Name:VU
Last Name:NGHIEM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:THUY
Other - Middle Name:VU
Other - Last Name:SANTIAGO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:10386 ALPHONSE ST UNIT G8
Mailing Address - Street 2:
Mailing Address - City:SANTEE
Mailing Address - State:CA
Mailing Address - Zip Code:92071-1289
Mailing Address - Country:US
Mailing Address - Phone:858-997-7971
Mailing Address - Fax:
Practice Address - Street 1:8270 LA MESA BLVD STE 202
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-5216
Practice Address - Country:US
Practice Address - Phone:619-713-0737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-27
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARBT-23-272134106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician