MEDICARE: PETER HAI NGUYEN ACSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor
2	101YM0800X	Mental Health Counselor	ASW71881	CA

General Provider Information

NPI Number	:	1114120235
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PETER HAI NGUYEN ACSW

Provider Business Mailing Address
First Line	:	18350 MOUNT LANGLEY ST STE 220
Second Line	:
City	:	FOUNTAIN VALLEY
State	:	CA
Zip	:	92708-6912
Country	:	US
Telephone Number	:	714-378-2620
Fax Number	:

Provider Business Practice Location Address
First Line	:	18350 MOUNT LANGLEY ST STE 220
Second Line	:
City	:	FOUNTAIN VALLEY
State	:	CA
Zip	:	92708-6912
Country	:	US
Telephone Number	:	714-378-2620
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/06/2007
Last Update Date	:	03/17/2018

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