Healthcare Provider Details

I. General information

NPI: 1811523038
Provider Name (Legal Business Name): VIVIAN TRAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2020
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

570 W BROWN RD
MESA AZ
85201-3203
US

IV. Provider business mailing address

3708 E VALENCIA DR
PHOENIX AZ
85042-9655
US

V. Phone/Fax

Practice location:
  • Phone: 480-344-2000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number011140
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number011140
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: