Provider Demographics
NPI:1619480035
Name:NGUYEN, THIEN NGOC (ND, DC, LAC)
Entity type:Individual
Prefix:DR
First Name:THIEN
Middle Name:NGOC
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:ND, DC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9535 DUCHESS LN
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95209-1953
Mailing Address - Country:US
Mailing Address - Phone:408-605-9668
Mailing Address - Fax:
Practice Address - Street 1:621 TULLY RD # 232
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95111-1013
Practice Address - Country:US
Practice Address - Phone:408-605-9668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-07
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC60812081171100000X
CA172V00000X
CAND1058175F00000X
CADC35200111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist
No172V00000XOther Service ProvidersCommunity Health Worker
No175F00000XOther Service ProvidersNaturopath