Provider Demographics
NPI:1447815717
Name:NGUYEN, DUYEN NGOC (AMFT)
Entity type:Individual
Prefix:
First Name:DUYEN
Middle Name:NGOC
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18700 BEACH BLVD STE 160
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92648-2073
Mailing Address - Country:US
Mailing Address - Phone:714-580-5797
Mailing Address - Fax:
Practice Address - Street 1:18700 BEACH BLVD STE 160
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648-2073
Practice Address - Country:US
Practice Address - Phone:714-580-5797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-02
Last Update Date:2019-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA102753106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty