Provider Demographics
NPI:1982064531
Name:NGUYEN, THIERRY
Entity Type:Individual
Prefix:
First Name:THIERRY
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9353 BOLSA AVE
Mailing Address - Street 2:SUITE K9
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-5951
Mailing Address - Country:US
Mailing Address - Phone:714-553-9530
Mailing Address - Fax:951-329-3434
Practice Address - Street 1:14172 FRANCES ST
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-4114
Practice Address - Country:US
Practice Address - Phone:714-553-9530
Practice Address - Fax:951-329-3434
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-24
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)