Healthcare Provider Details

I. General information

NPI: 1356250807
Provider Name (Legal Business Name): THE QUOC MAI EDS, NCSP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15151 TEMPLE ST
WESTMINSTER CA
92683-6230
US

IV. Provider business mailing address

13100 GILBERT ST APT 1
GARDEN GROVE CA
92844-2141
US

V. Phone/Fax

Practice location:
  • Phone: 714-898-8389
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number260161553
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: