Provider Demographics
NPI:1881480788
Name:NGUYEN, JOHNNY QUANG (MSN, FNP)
Entity type:Individual
Prefix:
First Name:JOHNNY
Middle Name:QUANG
Last Name:NGUYEN
Suffix:
Gender:
Credentials:MSN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9231 OBSIDIAN DR
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-7345
Mailing Address - Country:US
Mailing Address - Phone:714-933-0636
Mailing Address - Fax:
Practice Address - Street 1:4902 IRVINE CENTER DR STE 105
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-3334
Practice Address - Country:US
Practice Address - Phone:949-651-9671
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-17
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95226627163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse