Healthcare Provider Details

I. General information

NPI: 1356998223
Provider Name (Legal Business Name): TRANG M NGUYEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2019
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2940 SUMMIT ST STE 2D
OAKLAND CA
94609-3416
US

IV. Provider business mailing address

248 3RD ST # 1225
OAKLAND CA
94607-4375
US

V. Phone/Fax

Practice location:
  • Phone: 141-529-5461
  • Fax:
Mailing address:
  • Phone: 408-896-8924
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number123323
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: