Healthcare Provider Details

I. General information

NPI: 1598631574
Provider Name (Legal Business Name): JESSICA-LIEN NGUYEN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JESSICA NGUYEN FNP

II. Dates (important events)

Enumeration Date: 10/15/2025
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 N ROSE AVE STE 470
OXNARD CA
93030-7659
US

IV. Provider business mailing address

1700 N ROSE AVE STE 470
OXNARD CA
93030-7659
US

V. Phone/Fax

Practice location:
  • Phone: 805-988-7080
  • Fax: 805-988-7081
Mailing address:
  • Phone: 805-988-7080
  • Fax: 805-988-7081

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95036151
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: