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General NPI Number Information
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NPI Number | 1144572009
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Entity Type | Individual
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Provider Name | ANNIE NGUYEN BUI PSY.D
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Gender | Female
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Dates
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Enumeration Date | 10/02/2012
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Last Update Date | 10/24/2019
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Provider Practice Location Address
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Address Line | 1634 W 19TH ST # C
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City | SANTA ANA
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State | CA
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Zip | 92706-2301
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Country | US
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Telephone | 714-479-0102
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Fax |
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Provider Business Mailing Address
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Address Line | 13894 BROOKHURST ST
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City | GARDEN GROVE
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State | CA
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Zip | 92843-3173
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Country | US
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Telephone | 626-246-8678
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 29647
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License Number State | CA
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