Provider Demographics
NPI:1053705087
Name:NGUYEN, VENUS
Entity type:Individual
Prefix:
First Name:VENUS
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1699 N IMPERIAL AVE
Mailing Address - Street 2:
Mailing Address - City:EL CENTRO
Mailing Address - State:CA
Mailing Address - Zip Code:92243-1320
Mailing Address - Country:US
Mailing Address - Phone:442-283-3494
Mailing Address - Fax:888-631-5150
Practice Address - Street 1:1699 N IMPERIAL AVE
Practice Address - Street 2:
Practice Address - City:EL CENTRO
Practice Address - State:CA
Practice Address - Zip Code:92243-1320
Practice Address - Country:US
Practice Address - Phone:760-352-2551
Practice Address - Fax:888-631-5155
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-27
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95001830363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily