Individual
HALEY NGUYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
661 W 1ST ST STE G, TUSTIN, CA 92780-2939
(714) 665-9890
(714) 665-9891
Mailing address
661 W 1ST ST STE G, TUSTIN, CA 92780-2939
(714) 665-9890
(714) 665-9891
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1154362
PHYSICIAN ASSISTANT CERTIFICATION
—
01
—
PA55965
PHYSICIAN ASSISTANT LICENSE
CA
Enumeration date
10/15/2018
Last updated
07/26/2024
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