MEDICARE: HUY G HUYNH MFT TRAINEE

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	106H00000X	Marriage & Family Therapist	158290	CA

General Provider Information

NPI Number	:	1578059556
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HUY G HUYNH MFT TRAINEE

Provider Business Mailing Address
First Line	:	9181 TRASK AVE APT 8
Second Line	:
City	:	GARDEN GROVE
State	:	CA
Zip	:	92844-2238
Country	:	US
Telephone Number	:	657-377-8149
Fax Number	:

Provider Business Practice Location Address
First Line	:	2009 PALO VERDE AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90815-3322
Country	:	US
Telephone Number	:	562-794-7008
Fax Number	:	562-632-5192

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

Provider Enumeration Date	:	07/02/2018
Last Update Date	:	10/10/2025

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