Healthcare Provider Details
I. General information
NPI: 1326375684
Provider Name (Legal Business Name): DIEP MARIE VUONG AA II
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 11/06/2009
Last Update Date: 11/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
982 MISSION ST
SAN FRANCISCO CA
94103-2911
US
IV. Provider business mailing address
982 MISSION ST
SAN FRANCISCO CA
94103-2911
US
V. Phone/Fax
- Phone: 415-597-8099
- Fax: 415-597-8004
- Phone: 415-597-8099
- Fax: 415-597-8004
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: