MEDICARE: JENNIFER 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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1932915733
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER NGUYEN

Provider Business Mailing Address
First Line	:	4262 CASCADE SKY DR
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76005-1164
Country	:	US
Telephone Number	:	760-410-9046
Fax Number	:

Provider Business Practice Location Address
First Line	:	6620 HAWKS CREEK AVE
Second Line	:
City	:	WESTWORTH VILLAGE
State	:	TX
Zip	:	76114-4056
Country	:	US
Telephone Number	:	817-921-9095
Fax Number	:

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

Provider Enumeration Date	:	12/06/2024
Last Update Date	:	12/06/2024

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Directions to “ JENNIFER NGUYEN ” Practice Location

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