Provider Demographics
NPI:1932595220
Name:NGUYEN, LYLEANNA K (MSN, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:LYLEANNA
Middle Name:K
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:MSN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13322 SANDRA PL
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92843-2712
Mailing Address - Country:US
Mailing Address - Phone:714-360-3559
Mailing Address - Fax:
Practice Address - Street 1:7212 ORANGETHORPE AVE
Practice Address - Street 2:9A
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90621-3341
Practice Address - Country:US
Practice Address - Phone:714-503-6550
Practice Address - Fax:714-562-8729
Is Sole Proprietor?:No
Enumeration Date:2015-04-13
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95056697163W00000X
CA95015250363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse