Healthcare Provider Details

I. General information

NPI: 1679083414
Provider Name (Legal Business Name): DOAN NGOC DAO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2017
Last Update Date: 11/14/2022
Certification Date: 11/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

511 N BROOKHURST ST STE 200
ANAHEIM CA
92801-5229
US

IV. Provider business mailing address

511 N BROOKHURST ST STE 200
ANAHEIM CA
92801-5229
US

V. Phone/Fax

Practice location:
  • Phone: 714-780-0750
  • Fax: 714-780-0757
Mailing address:
  • Phone: 714-780-0750
  • Fax: 714-780-0757

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberASW109960
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: