Agere Trauma Work PSC

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Legal business name

AGERE TRAUMA WORK PSC

Practice address

2033 Gateway PL Unit 664
San Jose, CA 95110-3709

Phone

(408) 758-0805

NPI assigned

Jun 7, 2024

Organization subpart

No

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

Authorized official

Name

Diane Ngoc Nguyen, LMFTNPI 1083962419

Title

Owner/Ceo

Phone

(408) 758-0805

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Diane Ngoc Nguyen, LMFT

  • Marriage & Family Therapist
  • San Jose, CA
  • NPI 1083962419
  NPD Authorized official

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

{
    "created_epoch": "1717718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717718400000",
    "number": "1740022235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3203 EVERDALE DR",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951483406",
            "telephone_number": "408-758-0805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2033 GATEWAY PL UNIT 664",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951103709",
            "telephone_number": "408-758-0805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGERE TRAUMA WORK PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-07",
        "last_updated": "2024-06-07",
        "certification_date": "2024-06-07",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "DIANE",
        "authorized_official_middle_name": "NGOC",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "408-758-0805",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Navy Casiano Agbanlog II, BT
• Jaelyn Agbayani
• Renz Agbayani
• Taylor Agbulos
• Belinda Mangrobang Agdipa, RN
• Heena Aggarwal
• Meenakshi Aggarwal, MD
• Sangeeta Aggarwal, MD
• Ravi Kumar Aggu Sher, MD
• Agheg. M. Yenikomshian, M.D. a Professional Corporation (Center for Plastic and Cosmetic Surgery)

• Marriage & Family Therapist in San Jose, CA
• Providers in San Jose, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2024; 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.