Provider Demographics
NPI:1952766230
Name:NGUYEN, JENNIFER PHUONG (LMFT 152143)
Entity type:Individual
Prefix:MISS
First Name:JENNIFER
Middle Name:PHUONG
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:LMFT 152143
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19050 MALAGUERRA AVE
Mailing Address - Street 2:
Mailing Address - City:MORGAN HILL
Mailing Address - State:CA
Mailing Address - Zip Code:95037-9032
Mailing Address - Country:US
Mailing Address - Phone:408-961-4636
Mailing Address - Fax:
Practice Address - Street 1:19050 MALAGUERRA AVE
Practice Address - Street 2:
Practice Address - City:MORGAN HILL
Practice Address - State:CA
Practice Address - Zip Code:95037-9032
Practice Address - Country:US
Practice Address - Phone:408-961-4636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-30
Last Update Date:2024-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA152143106H00000X
171M00000X
CA104212106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator