Healthcare Provider Details

I. General information

NPI: 1811792989
Provider Name (Legal Business Name): MRS. CALINA NGUYEN FUJIMOTO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS CALINA NGUYEN

II. Dates (important events)

Enumeration Date: 02/13/2025
Last Update Date: 02/13/2025
Certification Date: 02/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7200 TRASK AVE
WESTMINSTER CA
92683-2626
US

IV. Provider business mailing address

431 E MEADOWBROOK AVE
ORANGE CA
92865-1317
US

V. Phone/Fax

Practice location:
  • Phone: 714-894-7264
  • Fax:
Mailing address:
  • Phone: 909-262-7980
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: