Individual provider Active NPI

Annie Thu Nguyen

  • Clinical Social Worker
  • San Jose, CA
National Provider Identifier
1902192024
Registry record updated Jun 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS 22887 Issued in CA
Practice address
2400 Moorpark Ave
300
San Jose, CA 95128-2631
Phone
(408) 975-2730
Fax
(408) 975-2762
NPI assigned
Jun 27, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCS 22887 CA Primary

Addresses

Primary practice location

2400 Moorpark Ave
300
San Jose, CA 95128-2631

Mailing address

1647 Everglades Dr
Milpitas, CA 95035-6532
Phone (408) 975-2730

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180501001028 CA Practitioner - Clinical Social Worker 6103180021 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1999
Medicare assignment
May accept Medicare assignment
Group practices

Practice addresses (Care Compare)

2400 Moorpark Ave
Suite 300
San Jose, CA 95128-2680
Phone (408) 975-2763

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS 22887CAMDClinical Social Worker
22887CAMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Asian Americans for Community Involvement of Santa Clara County, Inc CurrentSince Aug 19, 2025 Accepting new patients

Locations

266 N Jackson Ave
Ste 4
San Jose, CA 95116
Phone (408) 975-2763

749 Story Rd
Ste 50
San Jose, CA 95122

2400 Moorpark Ave
Ste 300
San Jose, CA 95128
Phone (408) 975-2763

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1309132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309132800000",
    "number": "1902192024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1647 EVERGLADES DR",
            "city": "MILPITAS",
            "state": "CA",
            "postal_code": "950356532",
            "telephone_number": "408-975-2730",
            "fax_number": "408-975-2762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 MOORPARK AVE",
            "address_2": "300",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282631",
            "telephone_number": "408-975-2730",
            "fax_number": "408-975-2762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "ANNIE",
        "middle_name": "THU",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-27",
        "last_updated": "2011-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS 22887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.