Minhdan Thuy Ta, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY29358 Issued in CA

Practice address

11660 Church St Apt 217
Rancho Cucamonga, CA 91730-8930

Phone

(909) 764-9795

NPI assigned

Sep 7, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1504742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1184142341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11660 CHURCH ST APT 217",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917308930",
            "telephone_number": "909-764-9795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11660 CHURCH ST APT 217",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917308930",
            "telephone_number": "909-764-9795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TA",
        "first_name": "MINHDAN",
        "middle_name": "THUY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-07",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY29358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Tyler J Syrett
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• Senia Elizabeth Tabora
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• Christina Tadeja, M.A., B.C.B.A.
• Joseph H Tadros, PHARMD

• Psychologist in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.