Provider Demographics
NPI:1366335390
Name:MONDIENTZ, TIEN THUY (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:TIEN
Middle Name:THUY
Last Name:MONDIENTZ
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3865 VALOR AVE
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93619-7967
Mailing Address - Country:US
Mailing Address - Phone:559-776-9684
Mailing Address - Fax:
Practice Address - Street 1:7210 N MILBURN AVE STE 105
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93722-8449
Practice Address - Country:US
Practice Address - Phone:559-224-5003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-29
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95035265363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily