Healthcare Provider Details

I. General information

NPI: 1821803297
Provider Name (Legal Business Name): NANCY LE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/11/2025
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12966 EUCLID ST
GARDEN GROVE CA
92840-5200
US

IV. Provider business mailing address

12092 9TH ST
GARDEN GROVE CA
92840-3531
US

V. Phone/Fax

Practice location:
  • Phone: 714-823-4770
  • Fax:
Mailing address:
  • Phone: 626-944-6886
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number164545
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: