Healthcare Provider Details

I. General information

NPI: 1639363666
Provider Name (Legal Business Name): CHRYSTELLE HONG-HANH NGUYEN REGISTERED NURSE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/04/2007
Last Update Date: 09/04/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 W SANTA ANA BLVD STE 100
SANTA ANA CA
92701-4134
US

IV. Provider business mailing address

3927 RIO HONDO AVE
ROSEMEAD CA
91770-2116
US

V. Phone/Fax

Practice location:
  • Phone: 714-347-0300
  • Fax:
Mailing address:
  • Phone: 626-914-4902
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number520444
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: