Healthcare Provider Details

I. General information

NPI: 1104339522
Provider Name (Legal Business Name): ANH NGOC LE ND, LAC, LMP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2017
Last Update Date: 01/19/2024
Certification Date: 01/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2530 J ST STE 100
SACRAMENTO CA
95816-4849
US

IV. Provider business mailing address

2530 J ST STE 100
SACRAMENTO CA
95816-4849
US

V. Phone/Fax

Practice location:
  • Phone: 916-446-2591
  • Fax:
Mailing address:
  • Phone: 916-446-2591
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC60805280
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberNT60843141
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberND1329
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA60504707
License Number StateWA
# 5
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: