Individual provider Active NPI

John Huynh Nguyen

  • Clinical Social Worker
  • Anaheim, CA
National Provider Identifier
1114589314
Registry record updated Jul 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
121502 Issued in CA
Practice address
3055 W Orange Ave Ste 105
Anaheim, CA 92804-3152
Phone
(714) 653-0402
NPI assigned
Jul 8, 2019
Last updated
Jul 8, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 121502 CA Primary

Addresses

Primary practice location

3055 W Orange Ave Ste 105
Anaheim, CA 92804-3152

Mailing address

12966 Euclid St Ste 280
Garden Grove, CA 92840-9202
Phone (714) 653-0402

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20251011000019 CA Practitioner - Clinical Social Worker 7517454804 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

22471 Aspan St
Lake Forest, CA 92630-1644
Phone 71454775591105

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
121502CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Orange County Association for Mental Health CurrentSince Aug 1, 2025 Accepting new patients
Orange County Association for Mental Health Current Accepting new patients
Southland Integrated Services, Inc. Past Accepting new patients
Southland Integrated Services, Inc. PastSince Dec 18, 2015 Accepting new patients

Locations

3055 W Orange Ave
Ste 105
Anaheim, CA 92804
Phone (714) 547-7559

22471 Aspan St
Ste 103
Lake Forest, CA 92630
Phone (714) 547-7559

1971 E 4th St
Ste 130A
Santa Ana, CA 92705
Phone (714) 547-7559

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GFCABD

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1562544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720396800000",
    "number": "1114589314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12966 EUCLID ST STE 280",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928409202",
            "telephone_number": "714-653-0402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3055 W ORANGE AVE STE 105",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928043152",
            "telephone_number": "714-653-0402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "JOHN",
        "middle_name": "HUYNH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-08",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "121502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.