Pravongviengkham, Nidia Delsy

Pravongviengkham, Nidia Delsy is an sole proprietor health care provider with primary practice located at 13800 Heacock St Ste C236 , Moreno Valley CA 92553-3364. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Marriage & Family Therapist, Other Service Providers / Case Manager/Care Coordinator. Other Service Providers / Case Manager/Care Coordinator is her primary health care specialty. Pravongviengkham, Nidia Delsy can be contacted via phone (951) 653-0819.

Contact Information

Primary practice address
13800 Heacock St Ste C236 Moreno Valley CA 92553-3364
Phone: (951) 653-0819
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X IMF 54676 California
Other Service Providers / Case Manager/Care Coordinator 171M00000X

Profile Details

NPI number 1235384066
LBN Legal business name Pravongviengkham, Nidia Delsy
Credentials M.S.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 20th, 2008
Last updated Nov 14th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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