Individual provider Active NPI

Thu Anh Nguyen

  • Nurse Practitioner
  • Tustin, CA
National Provider Identifier
1902229578
Registry record updated Jun 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95000294 Issued in CA
Practice address
661 W 1St St Ste G
Tustin, CA 92780-2939
Phone
(714) 665-9890
Fax
(714) 665-9891
NPI assigned
Feb 1, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95000294 CA
Nurse Practitioner 363L00000X 95000294 CA Primary

Addresses

Primary practice location

661 W 1St St Ste G
Tustin, CA 92780-2939

Mailing address

9082 Washington Ave
Westminster, CA 92683-5528
Phone (714) 710-6410

Other practice location 1

9918 Katella Ave Ste A-C
Anaheim, CA 92804-6465
Phone (714) 644-9494

Other practice location 2

11180 Warner Ave Ste 353
Fountain Valley, CA 92708-7516
Phone (714) 968-6789

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
I20170524002463 CA Practitioner - Nurse Practitioner 1254608144 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
95000294CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Le, Nguyen, Tram, Nguyen & Tran Medical Corporation CurrentSince May 1, 2017 Accepting new patients
Families Together of Orange County CurrentSince Jun 1, 2023 Accepting new patients
Families Together of Orange County CurrentSince Jun 1, 2023 Accepting new patients

Locations

9918 Katella Ave
Ste Ac
Anaheim, CA 92804
Phone (714) 644-9494

11180 Warner Ave
Ste 353
Fountain Vly, CA 92708
Phone (714) 751-3540

661 W 1st St
Ste G
Tustin, CA 92780
Phone (714) 665-9890

15355 Brookhurst St
Ste 102108
Westminster, CA 92683
Phone (714) 531-2220

15355 Brookhurst St
Ste 102
Westminster, CA 92683
Phone (714) 531-2220

Organizations & group practices 3

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": "1391212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686268800000",
    "number": "1902229578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9082 WASHINGTON AVE",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926835528",
            "telephone_number": "714-710-6410",
            "fax_number": "714-710-6410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "661 W 1ST ST STE G",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927802939",
            "telephone_number": "714-665-9890",
            "fax_number": "714-665-9891"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9918 Katella Ave Ste A-C",
            "address_purpose": "LOCATION",
            "city": "Anaheim",
            "state": "CA",
            "postal_code": "928046465",
            "country_code": "US",
            "telephone_number": "714-644-9494",
            "fax_number": "714-644-9894",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11180 Warner Ave Ste 353",
            "address_purpose": "LOCATION",
            "city": "Fountain Valley",
            "state": "CA",
            "postal_code": "927087516",
            "country_code": "US",
            "telephone_number": "714-968-6789",
            "fax_number": "714-202-2626",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "THU",
        "middle_name": "ANH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-02-01",
        "last_updated": "2023-06-09",
        "certification_date": "2023-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95000294",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95000294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tustin, CA

Sources for this page

Verify at the official NPI Registry.