Basic Information
| Provider Information | |||||||||
| NPI: | 1891044640 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NGUYEN | ||||||||
| FirstName: | MARK | ||||||||
| MiddleName: | VINH | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PSY.D | ||||||||
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| Mailing Information | |||||||||
| Address1: | 19401 PARTHENIA ST APT 4020 | ||||||||
| Address2: | |||||||||
| City: | NORTHRIDGE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913243270 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9092488867 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 44750 60TH ST W | ||||||||
| Address2: | |||||||||
| City: | LANCASTER | ||||||||
| State: | CA | ||||||||
| PostalCode: | 935367619 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6617292000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/06/2012 | ||||||||
| LastUpdateDate: | 04/11/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | PSY29174 | CA | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.