Provider Demographics
NPI:1649479809
Name:NGUYEN, ELIZABETH K (MD)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:K
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:ELIZABETH
Other - Middle Name:K
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2230 STOCKTON BLVD
Mailing Address - Street 2:UC DAVIS DEPARTMENT OF PSYCHIATRY
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-1419
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:621 4TH ST STE 1
Practice Address - Street 2:
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95616-4151
Practice Address - Country:US
Practice Address - Phone:530-341-5561
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-17
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1012122084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry