Provider Demographics
NPI:1972495273
Name:NGO, JENIFER NGOC
Entity type:Individual
Prefix:
First Name:JENIFER
Middle Name:NGOC
Last Name:NGO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JENIFER
Other - Middle Name:NGOC
Other - Last Name:DAO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7251 NESTLE AVE
Mailing Address - Street 2:
Mailing Address - City:RESEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-3105
Mailing Address - Country:US
Mailing Address - Phone:818-938-0670
Mailing Address - Fax:
Practice Address - Street 1:7251 NESTLE AVE
Practice Address - Street 2:
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-3105
Practice Address - Country:US
Practice Address - Phone:818-938-0670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-19
Last Update Date:2025-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician