Healthcare Provider Details

I. General information

NPI: 1104737618
Provider Name (Legal Business Name): NGUYENPREDA PSYCHOLOGIST PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1370 BREA BLVD STE 210
FULLERTON CA
92835-4128
US

IV. Provider business mailing address

6739 E KENTUCKY AVE
ANAHEIM CA
92807-5023
US

V. Phone/Fax

Practice location:
  • Phone: 714-614-8773
  • Fax:
Mailing address:
  • Phone: 714-614-8773
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. DANA NGUYEN PREDA
Title or Position: OWNER
Credential: PHD
Phone: 714-614-8773