Healthcare Provider Details

I. General information

NPI: 1689506800
Provider Name (Legal Business Name): CHRISTINE THIEN NGUYEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8755 KERN AVE
GILROY CA
95020-4034
US

IV. Provider business mailing address

291 SPOSITO CIR
SAN JOSE CA
95136-2140
US

V. Phone/Fax

Practice location:
  • Phone: 669-205-4700
  • Fax:
Mailing address:
  • Phone: 408-712-5969
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number40957
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: