Healthcare Provider Details

I. General information

NPI: 1053132902
Provider Name (Legal Business Name): SARA NHU VO PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2024
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8881 FLETCHER PKWY STE 350-360
LA MESA CA
91942-3134
US

IV. Provider business mailing address

8881 FLETCHER PKWY STE 350-360
LA MESA CA
91942-3134
US

V. Phone/Fax

Practice location:
  • Phone: 858-279-1223
  • Fax:
Mailing address:
  • Phone: 858-279-1223
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95237721
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95032818
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: