Healthcare Provider Details

I. General information

NPI: 1316525405
Provider Name (Legal Business Name): LINDA T NGUYEN DSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2021
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7784 W 11TH ST UNIT 200
TRACY CA
95304-8832
US

IV. Provider business mailing address

7784 W 11TH ST UNIT 200
TRACY CA
95304-8832
US

V. Phone/Fax

Practice location:
  • Phone: 408-673-7996
  • Fax: 408-300-9371
Mailing address:
  • Phone: 408-673-7996
  • Fax: 408-300-9371

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number128274
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: