Minhdan Thuy Ta | Rancho Cucamonga, CA • PECOS Search

Minhdan Thuy Ta

Psychologist

Behavioral Health & Social Service Providers

11660 Church St Apt 217, Rancho Cucamonga, CA 91730-8930

PECOS Enrollment

Based on the most recent information from CMS, provider Minhdan Thuy Ta does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 33 days ago.

Profile Details

Provider ID
1184142341
Provider Type
Individual
Full Name
Ta, Minhdan Thuy
Title
Dr.
Credential
PH.D.

Gender
Female
Sole Proprietor
No
Enumeration Date
9/7/2017
Last Updated
7/21/2022

Contact Information

Practice Location

11660 Church St Apt 217, Rancho Cucamonga, CA 91730-8930

Unlisted Fax

Mailing Location

11660 Church St Apt 217, Rancho Cucamonga, CA 91730-8930

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 103T00000X Primary	Description Psychologist Behavioral Health & Social Service Providers	License PSY29358 California