Healthcare Provider Details

I. General information

NPI: 1639039530
Provider Name (Legal Business Name): ERIKA CLOVER NGUYEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ERIKA CLOVER NGUYEN

II. Dates (important events)

Enumeration Date: 11/13/2025
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2112 E 4TH ST STE 218E
SANTA ANA CA
92705-3840
US

IV. Provider business mailing address

18155 S 2ND ST
FOUNTAIN VALLEY CA
92708-4419
US

V. Phone/Fax

Practice location:
  • Phone: 213-222-6553
  • Fax: 213-559-9158
Mailing address:
  • Phone: 213-222-6553
  • Fax: 213-559-9158

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number139950
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: