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Provider Information for 1275995920


The following NPI(s) contain information matching your search criteria. Please select the NPI to view all the data associated with the NPI.

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

BAOTRAN AMANDA XUAN NGUYEN


Sex: Female

NPI: 1275995920
Last Updated: 2023-12-01
Certification Date: 2023-12-01

Details

NameValue
NPI1275995920
Enumeration Date2016-03-22
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 1555 PARKMOOR AVE
COUNSELING CENTER
SAN JOSE, CA 95128
United States

Phone: 408-282-0402 | Fax:405-282-0400
 
Primary Practice Address 1555 PARKMOOR AVE
SAN JOSE, CA 95128-2407
United States

Phone: 408-282-0402 | Fax:405-282-0400
 
Secondary Practice Address(es)

309 LENNON LN
SUITE 104
WALNUT CREEK, CA 94598-2491
United States

Phone: 925-210-9370 | Fax:925-210-0436
 

Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
No 101YM0800X - Counselor - Mental Health
No 103K00000X - Behavior Analyst
Yes 106H00000X - Marriage & Family Therapist CA143019