Healthcare Provider Details

I. General information

NPI: 1033076815
Provider Name (Legal Business Name): VIVIAN HUYNH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2026
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9401 JERONIMO RD
IRVINE CA
92618-1908
US

IV. Provider business mailing address

26356 VINTAGE WOODS RD APT 20P
LAKE FOREST CA
92630-7223
US

V. Phone/Fax

Practice location:
  • Phone: 714-744-7650
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: