MEDICARE: MICHELLE NGUYEN

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	225700000X	Massage Therapist

General Provider Information

NPI Number	:	1205514361
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE NGUYEN

Provider Business Mailing Address
First Line	:	3836 RAMIREZ CT
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95121-1278
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3836 RAMIREZ CT
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95121-1278
Country	:	US
Telephone Number	:	408-476-9965
Fax Number	:

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

Provider Enumeration Date	:	07/10/2023
Last Update Date	:	07/10/2023

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Directions to “ MICHELLE NGUYEN ” Practice Location

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