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NPI Code Detail

MEDICARE: MR. DREW ANH NGUYEN BCBA

MEDICARE: MR. DREW ANH NGUYEN BCBA
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
1103K00000XBehavior Analyst1084624CA
2103K00000XBehavior Analyst1-084624CA

General Provider Information

NPI Number : 1861754079
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DREW ANH NGUYEN BCBA
Provider Business Mailing Address
First Line : 3303 HARBOR BLVD STE B10
Second Line :
City : COSTA MESA
State : CA
Zip : 92626-1537
Country : US
Telephone Number : 714-292-9415
Fax Number : 714-551-9415
Provider Business Practice Location Address
First Line : 3303 HARBOR BLVD STE B10
Second Line :
City : COSTA MESA
State : CA
Zip : 92626-1537
Country : US
Telephone Number : 714-292-9415
Fax Number : 714-551-9415
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2012
Last Update Date : 06/17/2025

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