Individual provider Active NPI

Thien Ngoc Nguyen, ND, DC, LAC

  • Chiropractor
  • San Jose, CA
National Provider Identifier
1619480035
Registry record updated Mar 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC35200 Issued in CA
Practice address
621 Tully Rd # 232
San Jose, CA 95111-1013
Phone
(408) 605-9668
NPI assigned
Nov 7, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC60812081 WA
Community Health Worker 172V00000X CA
Naturopath 175F00000X ND1058 CA
Chiropractor 111N00000X DC35200 CA Primary

Addresses

Primary practice location

621 Tully Rd # 232
San Jose, CA 95111-1013

Mailing address

9535 Duchess LN
Stockton, CA 95209-1953
Phone (408) 605-9668

Other practice location 1

4410 N Pershing Ave Ste C1
Stockton, CA 95207-6960
Phone (209) 323-5338

Other practice location 2

9535 Duchess Ln
Stockton, CA 95209-1953
Phone (408) 605-9668

Other practice location 3

2530 J St Ste 100
Sacramento, CA 95816-4849
Phone (916) 446-2591

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DC35200CAMDChiropractor
AC60812081WAMDAcupuncturist
ND1058CAMDNaturopath

Practice roles

OrganizationSpecialtyStatusNew patients
Vietnamese Voluntary Foundation, Inc. Community Health Worker PastSince Sep 4, 2022 Accepting new patients

Organizations & group practices 1

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": "1510012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741737600000",
    "number": "1619480035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9535 DUCHESS LN",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952091953",
            "telephone_number": "408-605-9668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 TULLY RD # 232",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951111013",
            "telephone_number": "408-605-9668"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4410 N Pershing Ave Ste C1",
            "address_purpose": "LOCATION",
            "city": "Stockton",
            "state": "CA",
            "postal_code": "952076960",
            "country_code": "US",
            "telephone_number": "209-323-5338",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9535 Duchess Ln",
            "address_purpose": "LOCATION",
            "city": "Stockton",
            "state": "CA",
            "postal_code": "952091953",
            "country_code": "US",
            "telephone_number": "408-605-9668",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2530 J St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958164849",
            "country_code": "US",
            "telephone_number": "916-446-2591",
            "fax_number": "916-446-2592",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "THIEN",
        "middle_name": "NGOC",
        "name_prefix": "Dr.",
        "credential": "ND, DC, LAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-11-07",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "WA",
            "license": "AC60812081",
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "CA",
            "license": "ND1058",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC35200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2025; 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.