Provider Demographics
NPI:1831408426
Name:NGUYEN, ALICE DINH (NP)
Entity type:Individual
Prefix:PROF
First Name:ALICE
Middle Name:DINH
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18821 DELAWARE ST
Mailing Address - Street 2:STE 102
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92648-1926
Mailing Address - Country:US
Mailing Address - Phone:714-848-3482
Mailing Address - Fax:
Practice Address - Street 1:18821 DELAWARE ST
Practice Address - Street 2:STE 102
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648-1926
Practice Address - Country:US
Practice Address - Phone:714-848-3482
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-29
Last Update Date:2010-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA525903163W00000X
CA19535363L00000X
CAF0310070363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily