Provider Demographics
NPI:1144545302
Name:ALBA-NGUYEN, JACQUELINE C (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:JACQUELINE
Middle Name:C
Last Name:ALBA-NGUYEN
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:DR
Other - First Name:JACQUELINE
Other - Middle Name:C
Other - Last Name:NEWTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, MPH
Mailing Address - Street 1:2101 ALEXIAN DR STE D
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95116-1901
Mailing Address - Country:US
Mailing Address - Phone:408-272-6050
Mailing Address - Fax:
Practice Address - Street 1:2101 ALEXIAN DR STE D
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-1901
Practice Address - Country:US
Practice Address - Phone:408-272-6050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-31
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA119961207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program