Healthcare Provider Details

I. General information

NPI: 1093186892
Provider Name (Legal Business Name): NHATMINH NGUYEN NURSE PRACTITIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2015
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15944 LOS SERRANOS COUNTRY CLUB DR STE 110
CHINO HILLS CA
91709-3254
US

IV. Provider business mailing address

15944 LOS SERRANOS COUNTRY CLUB DR STE 110
CHINO HILLS CA
91709-3254
US

V. Phone/Fax

Practice location:
  • Phone: 909-219-9804
  • Fax: 909-219-9806
Mailing address:
  • Phone: 909-219-9804
  • Fax: 909-219-9806

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95003285
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: