Provider Demographics
NPI:1447997820
Name:HUYNH, DUNG (MA, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:DUNG
Middle Name:
Last Name:HUYNH
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 UNION AVE APT 327
Mailing Address - Street 2:
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95008-3518
Mailing Address - Country:US
Mailing Address - Phone:713-423-5056
Mailing Address - Fax:
Practice Address - Street 1:5140 COUNTRY LN
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95129-4217
Practice Address - Country:US
Practice Address - Phone:408-874-3450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-17
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA230319708235Z00000X
TX114957235Z00000X
CA34773235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0657199-01Medicaid