MEDICARE: INNA 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	3104A0625X	Assisted Living Facility (Mental Illness)	11218-AGC-1	NV

General Provider Information

NPI Number	:	1588524466
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	INNA NGUYEN

Provider Business Mailing Address
First Line	:	9737 FRANKIRST AVE
Second Line	:
City	:	NORTH HILLS
State	:	CA
Zip	:	91343-1914
Country	:	US
Telephone Number	:	818-730-3231
Fax Number	:

Provider Business Practice Location Address
First Line	:	9737 FRANKIRST AVE
Second Line	:
City	:	NORTH HILLS
State	:	CA
Zip	:	91343-1914
Country	:	US
Telephone Number	:	818-730-3231
Fax Number	:

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

Provider Enumeration Date	:	11/13/2025
Last Update Date	:	11/13/2025

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Directions to “ INNA NGUYEN ” Practice Location

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