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General NPI Number Information
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NPI Number | 1619315231
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Entity Type | Individual
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Provider Name | THANH HA FNP
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Gender | Female
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Dates
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Enumeration Date | 06/05/2013
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Last Update Date | 09/25/2021
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Provider Practice Location Address
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Address Line | 2221 STOCKTON BLVD, CYPRESS BLDG SUITE A
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City | SACRAMENTO
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State | CA
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Zip | 95817-1418
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Country | US
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Telephone | 916-734-3572
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Fax |
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Provider Business Mailing Address
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Address Line | 200 OCEANGATE SUITE 100
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City | LONG BEACH
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State | CA
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Zip | 90802-4317
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Country | US
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Telephone | 562-499-6191
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Fax | 562-499-6171
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 337956
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95004694
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License Number State | CA
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