Provider Demographics
NPI:1982463121
Name:HOANGGIA, DAT (CNS)
Entity Type:Individual
Prefix:
First Name:DAT
Middle Name:
Last Name:HOANGGIA
Suffix:
Gender:M
Credentials:CNS
Other - Prefix:
Other - First Name:DAT
Other - Middle Name:
Other - Last Name:HOANG-GIA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CNS
Mailing Address - Street 1:3801 MIRANDA AVE
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94304
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3801 MIRANDA AVE
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304-1290
Practice Address - Country:US
Practice Address - Phone:650-493-5000
Practice Address - Fax:999-999-9999
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-18
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5121163WG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0600XNursing Service ProvidersRegistered NurseGerontology