Healthcare Provider Details

I. General information

NPI: 1215854872
Provider Name (Legal Business Name): GINA NGUYEN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9681 GARDEN GROVE BLVD STE 104
GARDEN GROVE CA
92844-1548
US

IV. Provider business mailing address

2180 S WAVERLY DR
ANAHEIM CA
92802-3941
US

V. Phone/Fax

Practice location:
  • Phone: 714-462-6062
  • Fax: 714-462-6072
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number9500530
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: