Provider Demographics
NPI:1245977248
Name:NGUYEN, LINH
Entity type:Individual
Prefix:
First Name:LINH
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 M ST
Mailing Address - Street 2:
Mailing Address - City:RIO LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:95673-2218
Mailing Address - Country:US
Mailing Address - Phone:916-287-4067
Mailing Address - Fax:
Practice Address - Street 1:505 M ST
Practice Address - Street 2:
Practice Address - City:RIO LINDA
Practice Address - State:CA
Practice Address - Zip Code:95673-2218
Practice Address - Country:US
Practice Address - Phone:510-862-3538
Practice Address - Fax:916-287-4068
Is Sole Proprietor?:No
Enumeration Date:2022-05-19
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA699314164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse