Basic Information
| Provider Information | |||||||||
| NPI: | 1801845235 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DO | ||||||||
| FirstName: | THANH | ||||||||
| MiddleName: | NGOC | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 13702 TAFT ST | ||||||||
| Address2: | |||||||||
| City: | GARDEN GROVE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928433352 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7148967566 | ||||||||
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| Practice Location | |||||||||
| Address1: | 405 W 5TH ST | ||||||||
| Address2: | 550 | ||||||||
| City: | SANTA ANA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 927014519 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7148344707 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/10/2006 | ||||||||
| LastUpdateDate: | 11/07/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | LCS20330 | CA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.