Healthcare Provider Details

I. General information

NPI: 1225224744
Provider Name (Legal Business Name): CLAIRE MINH NGUYEN PA-C, L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CLAIRE MINH NGUYEN PA-C, L.AC.

II. Dates (important events)

Enumeration Date: 09/18/2007
Last Update Date: 06/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 21ST ST
SACRAMENTO CA
95811
US

IV. Provider business mailing address

1500 21ST ST
SACRAMENTO CA
95811-5216
US

V. Phone/Fax

Practice location:
  • Phone: 916-443-3299
  • Fax: 916-325-1984
Mailing address:
  • Phone: 916-443-3299
  • Fax: 916-325-1984

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA52280
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC11633
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: