Individual provider Active NPI

Therese Anne Vy-Phuc Thuy Nguyen, O.D.

  • Optometrist
  • San Diego, CA
National Provider Identifier
1699084442
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
14040 Issued in CA
Practice address
3350 La Jolla Village Dr
San Diego, CA 92161-1207
Phone
(858) 552-8585
NPI assigned
Sep 28, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 14040 CA Primary

Addresses

Primary practice location

3350 La Jolla Village Dr
San Diego, CA 92161-1207

Mailing address

7055 Park Mesa Way Unit 151
San Diego, CA 92111-5663
Phone (626) 344-0413

Other practice location 1

3801 Miranda Ave
Palo Alto, CA 94304-1207
Phone (650) 493-5000 ext. 62020

Other practice location 2

3350 La Jolla Village Dr
San Diego, CA 92161-1207
Phone (858) 552-8585 ext. 3298

Other practice location 3

3801 Miranda Ave
Palo Alto, CA 94304-1207
Phone (650) 493-5000 ext. 62020

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
14040CAMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1285632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1699084442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7055 PARK MESA WAY UNIT 151",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921115663",
            "telephone_number": "626-344-0413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3350 LA JOLLA VILLAGE DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921611207",
            "telephone_number": "858-552-8585"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3801 Miranda Ave",
            "address_purpose": "LOCATION",
            "city": "Palo Alto",
            "state": "CA",
            "postal_code": "943041207",
            "country_code": "US",
            "telephone_number": "650-493-5000 x62020",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3350 La Jolla Village Dr",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921611207",
            "country_code": "US",
            "telephone_number": "858-552-8585 x3298",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3801 Miranda Ave",
            "address_purpose": "LOCATION",
            "city": "Palo Alto",
            "state": "CA",
            "postal_code": "943041207",
            "country_code": "US",
            "telephone_number": "650-493-5000 x62020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "THERESE ANNE VY-PHUC",
        "middle_name": "THUY",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-28",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "14040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.