Individual provider Active NPI

Jasmine Quynh Dieu

  • Community/Behavioral Health Agency
  • Garden Grove, CA
National Provider Identifier
1790918407
Registry record updated Aug 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
D3869767 Issued in CA
Practice address
12755 Brookhurst St Ste 116
Garden Grove, CA 92840-4855
Phone
(714) 638-8277
NPI assigned
Aug 27, 2009
Last updated
Aug 27, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X D3869767 CA Primary

Addresses

Primary practice location

12755 Brookhurst St Ste 116
Garden Grove, CA 92840-4855

Mailing address

9543 El Rey Ave Apt 19
Fountain Valley, CA 92708-4642
Phone (714) 235-5209

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
D3869767CAMDCommunity/Behavioral Health Agency

NPI Registry JSON

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

{
    "created_epoch": "1251331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251331200000",
    "number": "1790918407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9543 EL REY AVE APT 19",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927084642",
            "telephone_number": "714-235-5209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12755 BROOKHURST ST STE 116",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928404855",
            "telephone_number": "714-638-8277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIEU",
        "first_name": "JASMINE",
        "middle_name": "QUYNH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-27",
        "last_updated": "2009-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": "D3869767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2009; 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.