Healthcare Provider Details

I. General information

NPI: 1780384412
Provider Name (Legal Business Name): BRIGHT PSYCHIATRY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2023
Last Update Date: 03/22/2023
Certification Date: 03/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5122 KATELLA AVE STE 202
LOS ALAMITOS CA
90720-2826
US

IV. Provider business mailing address

5122 KATELLA AVE STE 202
LOS ALAMITOS CA
90720-2826
US

V. Phone/Fax

Practice location:
  • Phone: 562-200-0254
  • Fax: 562-222-7170
Mailing address:
  • Phone: 562-200-0254
  • Fax: 562-222-7170

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. THUONG-PHUONG ARVID NGUYEN
Title or Position: PROVIDER
Credential: MD
Phone: 562-200-0254