Individual provider Active NPI

Tu Tram Huynh Nguyen, MSW

  • Social Worker
  • Los Angeles, CA
National Provider Identifier
1205316403
Registry record updated Oct 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
97109 Issued in CA
Practice address
1902 Marengo St Ste 107
Los Angeles, CA 90033-1378
Phone
(323) 276-6490
NPI assigned
Aug 16, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 97109 CA Primary
Student in an Organized Health Care Education/Training Program 390200000X
Rehabilitation Practitioner 225400000X

Addresses

Primary practice location

1902 Marengo St Ste 107
Los Angeles, CA 90033-1378

Mailing address

1902 Marengo St Ste 107
Los Angeles, CA 90033-1378
Phone (626) 689-9864

Other practice location 1

14600 Sherman Way Ste 100D
Van Nuys, CA 91405-2283
Phone (818) 374-6901

Other practice location 2

14600 Sherman Way Ste 100D
Van Nuys, CA 91405-2283
Phone (818) 374-6901

Other practice location 3

5321 Via Marisol
Los Angeles, CA 90042
Phone (323) 478-8200

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
I20240919002539 CA Practitioner - Clinical Social Worker 3577004332 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Los Angeles LGBT CenterGroup PAC ID 8729975453, 29 clinicians

Practice addresses (Care Compare)

1625 Schrader Blvd
Los Angeles, CA 90028-6213

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
125046CAMDMental Health Counselor
97109CAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Los Angeles LGBT Center CurrentSince Aug 21, 2024 Accepting new patients
Los Angeles LGBT Center CurrentSince Aug 21, 2024 Accepting new patients
Exodus Recovery Inc PastSince Aug 23, 2020 Accepting new patients
Exodus Recovery, Inc. PastSince Aug 23, 2020 Accepting new patients

Locations

1625 Schrader Blvd
Fl 3
Los Angeles, CA 90028
Phone (323) 993-7400

1625 Schrader Blvd
Los Angeles, CA 90028
Phone (323) 993-7400

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1534377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603152000000",
    "number": "1205316403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1902 MARENGO ST STE 107",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900331378",
            "telephone_number": "626-689-9864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1902 MARENGO ST STE 107",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900331378",
            "telephone_number": "323-276-6490"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14600 Sherman Way Ste 100D",
            "address_purpose": "LOCATION",
            "city": "Van Nuys",
            "state": "CA",
            "postal_code": "914052283",
            "country_code": "US",
            "telephone_number": "818-374-6901",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14600 Sherman Way Ste 100D",
            "address_purpose": "LOCATION",
            "city": "Van Nuys",
            "state": "CA",
            "postal_code": "914052283",
            "country_code": "US",
            "telephone_number": "818-374-6901",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5321 Via Marisol",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "90042",
            "country_code": "US",
            "telephone_number": "323-478-8200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "TU TRAM",
        "middle_name": "HUYNH",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-16",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "97109",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.