Provider Demographics
NPI:1265887244
Name:NGUYEN, WINSTON TUAN (NP)
Entity type:Individual
Prefix:
First Name:WINSTON
Middle Name:TUAN
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 99440
Mailing Address - Street 2:
Mailing Address - City:EMERYVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94662-9440
Mailing Address - Country:US
Mailing Address - Phone:916-365-4565
Mailing Address - Fax:
Practice Address - Street 1:2356 GOLD MEADOW WAY STE 130
Practice Address - Street 2:
Practice Address - City:GOLD RIVER
Practice Address - State:CA
Practice Address - Zip Code:95670-6330
Practice Address - Country:US
Practice Address - Phone:916-365-4565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-27
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95004223363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner