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General NPI Number Information
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NPI Number | 1649479809
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Entity Type | Individual
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Provider Name | ELIZABETH K NGUYEN M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/17/2007
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Last Update Date | 01/18/2024
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Provider Practice Location Address
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Address Line | 621 4TH ST STE 1
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City | DAVIS
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State | CA
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Zip | 95616-4151
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Country | US
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Telephone | 530-341-5561
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Fax |
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Provider Business Mailing Address
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Address Line | 2230 STOCKTON BLVD UC DAVIS DEPARTMENT OF PSYCHIATRY
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City | SACRAMENTO
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State | CA
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Zip | 95817-1419
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Country | US
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Telephone |
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | A101212
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License Number State | CA
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