Provider Demographics
NPI:1447841754
Name:NGUYEN, DORIS (LMFT)
Entity type:Individual
Prefix:
First Name:DORIS
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:238 W MAIN ST STE 201
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-7714
Mailing Address - Country:US
Mailing Address - Phone:714-831-5060
Mailing Address - Fax:
Practice Address - Street 1:238 W MAIN ST STE 201
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-7714
Practice Address - Country:US
Practice Address - Phone:714-558-9266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-29
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106523106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist