Provider Demographics
NPI:1396141891
Name:NGO DENNIS, KY BICH (MS)
Entity type:Individual
Prefix:
First Name:KY
Middle Name:BICH
Last Name:NGO DENNIS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:KY
Other - Middle Name:BICH
Other - Last Name:NGO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1221 ESSEX ST UNIT 3
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-3335
Mailing Address - Country:US
Mailing Address - Phone:858-754-8884
Mailing Address - Fax:
Practice Address - Street 1:928 FORT STOCKTON DR STE 213
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-1890
Practice Address - Country:US
Practice Address - Phone:858-754-8884
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-10
Last Update Date:2023-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF75950106H00000X
CA100105106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist