Mind Space Mental Health Inc

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

MIND SPACE MENTAL HEALTH INC

Practice address

31852 Coast Hwy Ste 400
Laguna Beach, CA 92651-6767

Phone

(949) 689-9754

NPI assigned

Oct 31, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Charles Tuan-Tu Song Nguyen, MD

Title

Doctor/Ceo

Phone

(949) 689-9754

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Hank Hung-Ta Lai, MD

  • Psychiatry Physician
  • Long Beach, CA
  • NPI 1255750246
  Medicare reassignment Care Compare group NPD
• Charles Tuan-Tu Song Nguyen, MD

  • Psychiatry Physician
  • Irvine, CA
  • NPI 1942380118
  Medicare reassignment Care Compare group NPD
• Hailong Dinh Vu, M.D.

  • Psychiatry Physician
  • Anaheim, CA
  • NPI 1578862256
  Medicare reassignment NPD
• Thu Phan, MSN, AGNP-C

  • Gerontology Nurse Practitioner
  • Downey, CA
  • NPI 1245779016
  Medicare reassignment

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

{
    "created_epoch": "1730332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730332800000",
    "number": "1720800667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31852 COAST HWY STE 400",
            "city": "LAGUNA BEACH",
            "state": "CA",
            "postal_code": "926516767",
            "telephone_number": "949-689-9754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31852 COAST HWY STE 400",
            "city": "LAGUNA BEACH",
            "state": "CA",
            "postal_code": "926516767",
            "telephone_number": "949-689-9754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND SPACE MENTAL HEALTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-31",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "TUAN-TU SONG",
        "authorized_official_title_or_position": "DOCTOR/CEO",
        "authorized_official_telephone_number": "949-689-9754",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debra Ann Miller, M.D.
• Kimberly Nicole Miller, MSN, RN
• Matthew John Miller, DDS
• Daniel C Mills, M.D.
• Bracha Tova Milstein
• Mindworks Connection Professional Nursing Corporation
• Miramar Health, Inc.
• Amelia Miscione
• Mission Hospital Regional Medical Center (Providence Mission Hospital)
• Mission Viejo Emergency Medical Associates, Inc.

• Psychiatry Physician in Laguna Beach, CA
• Providers in Laguna Beach, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.