Healthcare Provider Details

I. General information

NPI: 1447113147
Provider Name (Legal Business Name): KARINE VU-QUACH PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17782 COWAN STE A
IRVINE CA
92614-6041
US

IV. Provider business mailing address

17782 COWAN STE A
IRVINE CA
92614-6041
US

V. Phone/Fax

Practice location:
  • Phone: 949-722-7118
  • Fax:
Mailing address:
  • Phone: 949-722-7118
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95037576
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: