Provider Demographics
NPI:1043025216
Name:VU, BRENDAN KHOI
Entity type:Individual
Prefix:
First Name:BRENDAN
Middle Name:KHOI
Last Name:VU
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 1:3305 S BAKER ST
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92707-3823
Mailing Address - Country:US
Mailing Address - Phone:714-640-4325
Mailing Address - Fax:
Practice Address - Street 1:23046 AVENIDA DE LA CARLOTA
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-1548
Practice Address - Country:US
Practice Address - Phone:714-640-4325
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-12
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician