MEDICARE: DR. THUAN THI NGUYEN LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	LCSW17696	CA

General Provider Information

NPI Number	:	1285123133
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THUAN THI NGUYEN LCSW

Provider Business Mailing Address
First Line	:	4837 S WINNERS CIR APT F
Second Line	:
City	:	PALM SPRINGS
State	:	CA
Zip	:	92264-5882
Country	:	US
Telephone Number	:	310-456-4578
Fax Number	:

Provider Business Practice Location Address
First Line	:	1133 N PALM CANYON DR STE A
Second Line	:
City	:	PALM SPRINGS
State	:	CA
Zip	:	92262-4431
Country	:	US
Telephone Number	:	760-818-0505
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/07/2018
Last Update Date	:	10/17/2024

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