Provider Demographics
NPI:1447957105
Name:NGUYEN, KIEU-NHI (MT)
Entity type:Individual
Prefix:
First Name:KIEU-NHI
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:MT
Other - Prefix:
Other - First Name:KIEU-NHI
Other - Middle Name:
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CMT
Mailing Address - Street 1:12431 ROCK SPRINGS CT
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92843-4149
Mailing Address - Country:US
Mailing Address - Phone:714-204-2198
Mailing Address - Fax:
Practice Address - Street 1:12431 ROCK SPRINGS CT
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92843-4149
Practice Address - Country:US
Practice Address - Phone:714-204-2198
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-13
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA91909225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist