Healthcare Provider Details

I. General information

NPI: 1790598456
Provider Name (Legal Business Name): NGUYEN TRINH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/28/2025
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18111 BROOKHURST ST # 3100
FOUNTAIN VALLEY CA
92708-6728
US

IV. Provider business mailing address

8522 ELMER LN
GARDEN GROVE CA
92841-1043
US

V. Phone/Fax

Practice location:
  • Phone: 714-378-7390
  • Fax:
Mailing address:
  • Phone: 805-825-5471
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95033947
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: