Healthcare Provider Details

I. General information

NPI: 1285280685
Provider Name (Legal Business Name): LINH TRAN PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2019
Last Update Date: 10/22/2024
Certification Date: 10/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 E PACIFIC COAST HWY STE 320
LONG BEACH CA
90804-3271
US

IV. Provider business mailing address

4500 E PACIFIC COAST HWY STE 320
LONG BEACH CA
90804-3271
US

V. Phone/Fax

Practice location:
  • Phone: 424-284-2440
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Registered Nurse
License Number741184-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number402993
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95018807
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: