Healthcare Provider Details

I. General information

NPI: 1972767259
Provider Name (Legal Business Name): JANET KHANH TRAN PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2008
Last Update Date: 06/12/2023
Certification Date: 06/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4335 ATLANTIC AVE
LONG BEACH CA
90807-2803
US

IV. Provider business mailing address

4335 ATLANTIC AVE
LONG BEACH CA
90807-2803
US

V. Phone/Fax

Practice location:
  • Phone: 562-216-4900
  • Fax:
Mailing address:
  • Phone: 562-216-4900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberAMFT137577
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberPSB94024415
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License NumberPSB94024415
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: