Nidia Pravongviengkham, M.S

NPI 1235384066 · on the registry since 2008 · sole proprietor

Practice

Address: 13800 Heacock St Ste C236
Moreno Valley, CA 92553
Phone: (951) 653-0819
Organisation at this address: Epidaurus
Mary Cox, Lmft
Pacific Clinics
Spring Creek Oasis
County Of Riverside
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 77

Registry record

Primary taxonomy: 171M00000X
171M00000X
Also registered as: 106H00000X
Licence states on file: CA
From the registry's licence fields, which are often incomplete.
Sex: Female
Record last updated: 2012-11-14

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California