MEDICARE: CARLA RUTH TRINH MSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1215137492
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLA RUTH TRINH MSW

Provider Business Mailing Address
First Line	:	6560 FALCON AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90805-2523
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3460 E SAINT FRANCIS PL
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90805-3856
Country	:	US
Telephone Number	:	562-489-3615
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/24/2007
Last Update Date	:	06/20/2013

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