Provider Demographics
NPI:1639608250
Name:NANTHAVONGDOUANGSY, FILIPINA
Entity type:Individual
Prefix:MS
First Name:FILIPINA
Middle Name:
Last Name:NANTHAVONGDOUANGSY
Suffix:
Gender:
Credentials:
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 5252
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91791-5252
Mailing Address - Country:US
Mailing Address - Phone:714-780-1174
Mailing Address - Fax:714-844-9153
Practice Address - Street 1:1320 W PEARL ST
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-5941
Practice Address - Country:US
Practice Address - Phone:714-780-1174
Practice Address - Fax:714-844-9153
Is Sole Proprietor?:No
Enumeration Date:2017-06-07
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1098501041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical