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NPI Code Detail

MEDICARE: JESSICA NGOC-VI NGUYEN

MEDICARE: JESSICA NGOC-VI NGUYEN
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1578173274
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA NGOC-VI NGUYEN
Provider Business Mailing Address
First Line : 7567 AMADOR VALLEY BLVD STE 201
Second Line :
City : DUBLIN
State : CA
Zip : 94568-2443
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 121 E HISTORIC COLUMBIA RIVER HWY
Second Line :
City : TROUTDALE
State : OR
Zip : 97060-2006
Country : US
Telephone Number : 971-293-9237
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/06/2020
Last Update Date : 04/16/2024

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Directions to “ JESSICA NGOC-VI NGUYEN ” Practice Location

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