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General NPI Number Information
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NPI Number | 1861526246
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Entity Type | Individual
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Provider Name | ANNA ISABELL LEYVA NGUYEN
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Gender | Female
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Dates
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Enumeration Date | 03/15/2007
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Last Update Date | 12/13/2023
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Provider Practice Location Address
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Address Line | 310 HARBOR BLVD
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City | BELMONT
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State | CA
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Zip | 94002-4018
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Country | US
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Telephone | 800-686-0101
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Fax |
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Provider Business Mailing Address
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Address Line | 131 FOUNTAIN AVE
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City | PACIFIC GROVE
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State | CA
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Zip | 93950-2714
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Country | US
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Telephone | 408-772-2742
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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 | 104487
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License Number State | CA
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