Provider Demographics
NPI:1861122921
Name:NGUYEN, MELISSA DIEM VI
Entity type:Individual
Prefix:
First Name:MELISSA DIEM VI
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28991 OLD TOWN FRONT ST STE 101&103
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92590-5803
Mailing Address - Country:US
Mailing Address - Phone:951-556-8157
Mailing Address - Fax:951-414-6060
Practice Address - Street 1:28991 OLD TOWN FRONT ST STE 101&103
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-5803
Practice Address - Country:US
Practice Address - Phone:951-556-8157
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-13
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA37912355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant