Individual provider Active NPI

Bich Thu Thi Nguyen

  • Nurse Practitioner
  • Fountain Valley, CA
National Provider Identifier
1841912771
Registry record updated Sep 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95022589 Issued in CA
Practice address
11100 Warner Ave Ste 218
Fountain Valley, CA 92708-7511
Phone
(714) 641-9696
NPI assigned
Sep 16, 2022
Last updated
Sep 16, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95022589 CA Primary

Addresses

Primary practice location

11100 Warner Ave Ste 218
Fountain Valley, CA 92708-7511

Mailing address

11186 Stonecress Ave
Fountain Valley, CA 92708-2401
Phone (949) 536-1164

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251229001425 CA Practitioner - Nurse Practitioner 7214423359 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

13047 Artesia Blvd
Suite C200
Cerritos, CA 90703-1369

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95022589CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
PMD Medical PC CurrentSince Oct 1, 2025 Accepting new patients

Locations

13047 Artesia Blvd
Ste C200
Cerritos, CA 90703
Phone (562) 924-1555

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1663286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663286400000",
    "number": "1841912771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11186 STONECRESS AVE",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927082401",
            "telephone_number": "949-536-1164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11100 WARNER AVE STE 218",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927087511",
            "telephone_number": "714-641-9696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "BICH THU",
        "middle_name": "THI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-16",
        "last_updated": "2022-09-16",
        "certification_date": "2022-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95022589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

Verify at the official NPI Registry.