Provider Demographics
NPI:1902140080
Name:NGUYEN-BRIONES, THAO ANH (RN)
Entity Type:Individual
Prefix:
First Name:THAO
Middle Name:ANH
Last Name:NGUYEN-BRIONES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:THAO
Other - Middle Name:ANH
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:5730 PACKARD AVE
Mailing Address - Street 2:STE 100
Mailing Address - City:MARYSVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95901-7118
Mailing Address - Country:US
Mailing Address - Phone:530-749-6329
Mailing Address - Fax:
Practice Address - Street 1:5730 PACKARD AVE
Practice Address - Street 2:STE 100
Practice Address - City:MARYSVILLE
Practice Address - State:CA
Practice Address - Zip Code:95901-7118
Practice Address - Country:US
Practice Address - Phone:530-749-6329
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-15
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA806014171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator