Healthcare Provider Details

I. General information

NPI: 1942550959
Provider Name (Legal Business Name): UYENMY QUOC NGUYEN LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2012
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2050 WEST LN
STOCKTON CA
95205-3358
US

IV. Provider business mailing address

1142 PONCE DE LEON AVE
STOCKTON CA
95209-2620
US

V. Phone/Fax

Practice location:
  • Phone: 209-871-7890
  • Fax:
Mailing address:
  • Phone: 916-670-0780
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: