Healthcare Provider Details

I. General information

NPI: 1538630207
Provider Name (Legal Business Name): THANHTHUY THI NGUYEN RRT, RCP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/06/2018
Last Update Date: 12/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6600 BRUCEVILLE RD
SACRAMENTO CA
95823-4671
US

IV. Provider business mailing address

3219 SONATA CT
STOCKTON CA
95212-3836
US

V. Phone/Fax

Practice location:
  • Phone: 916-688-2571
  • Fax:
Mailing address:
  • Phone: 209-601-9386
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2279C0205X
TaxonomyCritical Care Registered Respiratory Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: