Healthcare Provider Details

I. General information

NPI: 1295635035
Provider Name (Legal Business Name): MS. DIANA KIEU LINH NGUYEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/05/2026
Last Update Date: 11/05/2026
Certification Date: 11/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41663 DATE ST STE 101B
MURRIETA CA
92562-7078
US

IV. Provider business mailing address

41663 DATE ST STE 101B
MURRIETA CA
92562-7078
US

V. Phone/Fax

Practice location:
  • Phone: 951-226-1846
  • Fax:
Mailing address:
  • Phone: 951-226-1846
  • 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 StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: