Individual
AILY THI NGUYEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CATC #167680
Contact information
Practice address
2136 EL CAJON BLVD, SAN DIEGO, CA 92104-1102
(619) 906-4663
(619) 269-8349
Mailing address
823 GATEWAY CENTER WAY, SAN DIEGO, CA 92102-4541
(619) 515-2555
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
167680
CA
Other
Enumeration date
04/23/2012
Last updated
04/28/2017
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