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NPI Code Detail

MEDICARE: TIMOTHY JOSEPH NGUYEN

MEDICARE: TIMOTHY JOSEPH 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
11041C0700XClinical Social WorkerLCSW101591CA

General Provider Information

NPI Number : 1649606013
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIMOTHY JOSEPH NGUYEN
Provider Business Mailing Address
First Line : 11501 DUBLIN BLVD STE 200
Second Line :
City : DUBLIN
State : CA
Zip : 94568-2827
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 11501 DUBLIN BLVD STE 200
Second Line :
City : DUBLIN
State : CA
Zip : 94568-2827
Country : US
Telephone Number : 310-217-7312
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/17/2013
Last Update Date : 12/22/2021

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Directions to “ TIMOTHY JOSEPH NGUYEN ” Practice Location

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