Provider Demographics
NPI:1750932141
Name:NGUYEN, HUYNH NGOC TU (NP)
Entity type:Individual
Prefix:
First Name:HUYNH NGOC TU
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:TUNGOC
Other - Middle Name:NGUYEN
Other - Last Name:HUYNH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:9041 MAGNOLIA AVE STE 302
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92503-3957
Mailing Address - Country:US
Mailing Address - Phone:951-637-9999
Mailing Address - Fax:951-637-9988
Practice Address - Street 1:9041 MAGNOLIA AVE STE 302
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92503-3957
Practice Address - Country:US
Practice Address - Phone:951-637-9999
Practice Address - Fax:951-637-9988
Is Sole Proprietor?:No
Enumeration Date:2019-09-26
Last Update Date:2019-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95106013363LG0600X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology