Individual provider Active NPI

Kristy Tram Nguyen

  • Clinical Psychologist
  • Los Angeles, CA
National Provider Identifier
1598309890
Registry record updated Jun 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY33281 Issued in CA
Practice address
3580 Wilshire Blvd Ste 2000
Los Angeles, CA 90010-2533
Phone
(213) 381-1250
Fax
(213) 383-4803
NPI assigned
Oct 30, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Clinical Psychologist 103TC0700X PSY33281 CA Primary

Addresses

Primary practice location

3580 Wilshire Blvd Ste 2000
Los Angeles, CA 90010-2533

Mailing address

3580 Wilshire Blvd Ste 2000
Los Angeles, CA 90010-2533
Phone (213) 381-1250

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY33281CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1572393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656028800000",
    "number": "1598309890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3580 WILSHIRE BLVD STE 2000",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900102533",
            "telephone_number": "213-381-1250",
            "fax_number": "213-383-4803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3580 WILSHIRE BLVD STE 2000",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900102533",
            "telephone_number": "213-381-1250",
            "fax_number": "213-383-4803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "KRISTY",
        "middle_name": "TRAM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-30",
        "last_updated": "2022-06-24",
        "certification_date": "2022-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY33281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 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.