Active NPI
Kensive Yu-Nguyen, ND
- Family Medicine Physician
- Mesa, AZ
National Provider Identifier
1699280594
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- ND959
- Practice address
- 2058 S Dobson Rd Ste 11
Mesa, AZ 85202-6455 - Phone
- (480) 628-9893
- NPI assigned
- Dec 13, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | ND959 | CA | Primary |
Addresses
Primary practice location
2058 S Dobson Rd Ste 11
Mesa, AZ 85202-6455
Mailing address
4333 Piedmont Ave
Oakland, CA 94611-4715
Phone (510) 891-1356
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
| License | State | Type | Specialty |
|---|---|---|---|
| ND959 | CA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1513123200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701388800000",
"number": "1699280594",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4333 PIEDMONT AVE",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946114715",
"telephone_number": "510-891-1356"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2058 S DOBSON RD STE 11",
"city": "MESA",
"state": "AZ",
"postal_code": "852026455",
"telephone_number": "480-628-9893"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YU-NGUYEN",
"first_name": "KENSIVE",
"name_prefix": "Dr.",
"credential": "ND",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-12-13",
"last_updated": "2023-12-01",
"certification_date": "2023-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "ND959",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.