Provider Demographics
NPI:1831336593
Name:NGUYEN, TERESA TRANG (DC, L AC NP)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:TRANG
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:DC, L AC NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:803 FIGUEROA ST
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:CA
Mailing Address - Zip Code:90744-2300
Mailing Address - Country:US
Mailing Address - Phone:310-830-0863
Mailing Address - Fax:
Practice Address - Street 1:803 FIGUEROA ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:CA
Practice Address - Zip Code:90744-2300
Practice Address - Country:US
Practice Address - Phone:310-830-0863
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-15
Last Update Date:2017-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC27500111N00000X
CA8980171100000X
CANP95000667363LF0000X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily