Provider Demographics
NPI:1982257010
Name:NGO, CATHERINE LOAN (NP)
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:LOAN
Last Name:NGO
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 1:17195 NEWHOPE ST
Mailing Address - Street 2:STE 107
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-4211
Mailing Address - Country:US
Mailing Address - Phone:714-782-2551
Mailing Address - Fax:
Practice Address - Street 1:17195 NEWHOPE ST STE 107
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-4211
Practice Address - Country:US
Practice Address - Phone:714-444-2414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-18
Last Update Date:2020-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95012256363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily