Healthcare Provider Details

I. General information

NPI: 1710897574
Provider Name (Legal Business Name): KAYLA THU-ANH NGUYEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 W EAST AVE
CHICO CA
95926-7238
US

IV. Provider business mailing address

13122 GREER DR
SAN DIEGO CA
92129-3399
US

V. Phone/Fax

Practice location:
  • Phone: 530-332-6138
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number311073
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: