Healthcare Provider Details

I. General information

NPI: 1427222942
Provider Name (Legal Business Name): ANNE NGUYEN NP PROFESSIONAL NURSING CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2008
Last Update Date: 07/10/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10203 WINECREEK CT
SAN DIEGO CA
92127-3728
US

IV. Provider business mailing address

10203 WINECREEK CT
SAN DIEGO CA
92127-3728
US

V. Phone/Fax

Practice location:
  • Phone: 714-470-0621
  • Fax:
Mailing address:
  • Phone: 714-470-0621
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License NumberRN 539313
License Number StateCA

VIII. Authorized Official

Name: ANNE NGUYEN
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 714-470-0621