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General NPI Number Information
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NPI Number | 1033694435
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Entity Type | Individual
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Provider Name | ELIZABETH NGOC NGUYEN
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Gender | Female
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Dates
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Enumeration Date | 10/01/2018
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Last Update Date | 01/04/2024
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Provider Practice Location Address
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Address Line | 1230 ROSECRANS AVE STE 300
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City | MANHATTAN BEACH
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State | CA
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Zip | 90266-2494
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Country | US
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Telephone | 213-222-8402
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Fax |
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Provider Business Mailing Address
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Address Line | 15041 JACKSON ST UNIT 653
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City | MIDWAY CITY
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State | CA
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Zip | 92655-2032
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Country | US
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Telephone | 657-233-1833
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | AMFT136674
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License Number State | CA
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