Van John Nguyen, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY32365 Issued in CA

Practice address

5348 Carroll Canyon Rd Ste 101
San Diego, CA 92121-1753

Phone

(858) 202-1546

NPI assigned

Apr 20, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other names 1

• Dr. John Nguyen Professional name

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pacific Neurobehavioral Clinic IncGroup PAC ID 9234454422, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Pacific Neurobehavioral Clinic: a Psychological Corporation

  • Community/Behavioral Health Agency
  • San Diego, CA
  • NPI 1952724817
  Medicare reassignment Care Compare group NPD
• Michael Moon MD a Medical Corporation

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • San Diego, CA
  • NPI 1629023387
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614729600000",
    "number": "1063630770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11021 CATARINA LN UNIT 300",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921285691",
            "telephone_number": "858-740-4455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5348 CARROLL CANYON RD STE 101",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211753",
            "telephone_number": "858-202-1546"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "995 Gateway Center Way",
            "address_2": "Suite 300",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921024500",
            "country_code": "US",
            "telephone_number": "619-398-2156",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "VAN",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-20",
        "last_updated": "2021-03-03",
        "certification_date": "2021-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": "CA",
            "license": "PSY32365",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY32365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOHN",
            "last_name": "NGUYEN",
            "prefix": "DR.",
            "credential": "PH.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Tuan Thanh Nguyen, PHARMD.
• Tuan-Anh T. Nguyen, M.D.
• Tue Thi Nguyen, MD
• Tuyet Mai T Nguyen, D.D.S.
• Ty Bich Nguyen, PHARM.D.
• Vanessa Kvan Nguyen
• VI Nhat Nguyen, PHARM.D.
• VI T. Nguyen, M.D.
• VI Tuong Thi Nguyen, DO
• VI-Van Nguyen

• Clinical Psychologist in San Diego, CA
• Providers in San Diego, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.