Provider Demographics
NPI:1356958557
Name:NGUYEN, MICHAEL TANG HIEU (PMHNP-BC, MSN, RN)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:TANG HIEU
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:PMHNP-BC, MSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 LISBON ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94112-2705
Mailing Address - Country:US
Mailing Address - Phone:415-238-7320
Mailing Address - Fax:
Practice Address - Street 1:355 LISBON ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94112-2705
Practice Address - Country:US
Practice Address - Phone:415-238-7320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-30
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95202229163W00000X
CA95018489363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse