Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kathlene Manimtim Nguyen

Individual provider Nurse Practitioner · NPI 1699415620

Kathlene Manimtim Nguyen is a Nurse Practitioner in Fontana, California. Qualified in 2021, 5 years ago. Licensed in California.

Years since qualifying
5
Licensed in
CA
In the registry since
2022
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Practice location Address checks out

7159 Myrtle Pl
Fontana, CA 92336-5706
Phone: (619) 415-9181
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 95020377 (CA)

Record details

NPI number1699415620
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMarch 29, 2022
Last updated in NPPESMarch 29, 2022
Certification dateMarch 29, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Accepts Medicare assignment Not indicated

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