Individual provider Active NPI

Kaitlyn Lien Nguyen, PA

  • Physician Assistant
  • Tustin, CA
National Provider Identifier
1982360913
Registry record updated Oct 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA61097 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
Nov 15, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA61097 CA Primary

Addresses

Primary practice location

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

Mailing address

661 W 1St St Ste G
Tustin, CA 92780-2939
Phone (714) 665-9890

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 A-C
Fountain Valley, CA 92708-7501
Phone (714) 698-6789

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
I20220727003999 CA Practitioner - Physician Assistant 2668854399 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA61097CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Families Together of Orange County CurrentSince Aug 1, 2024 Accepting new patients
Algos Inc., a Medical Corporation CurrentSince Jun 3, 2022 Accepting new patients
Algos Inc., a Medical Corporation CurrentSince Jun 3, 2022 Accepting new patients
Families Together of Orange County PastSince Jan 21, 2024 Accepting new patients
Algos Inc., a Medical Corporation Past Accepting new patients

Locations

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

16415 Colorado Ave
Ste 402
Paramount, CA 90723
Phone (562) 207-4644

1017 S Fair Oaks Ave
Pasadena, CA 91105
Phone (626) 403-6200

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

Organizations & group practices 7

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": "1636934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761177600000",
    "number": "1982360913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "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"
        },
        {
            "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 A-C",
            "address_purpose": "LOCATION",
            "city": "Fountain Valley",
            "state": "CA",
            "postal_code": "927087501",
            "country_code": "US",
            "telephone_number": "714-698-6789",
            "fax_number": "714-202-2626",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "KAITLYN",
        "middle_name": "LIEN",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-15",
        "last_updated": "2025-10-23",
        "certification_date": "2025-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA61097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tustin, CA

Sources for this page

Verify at the official NPI Registry.