Healthcare Provider Details

I. General information

NPI: 1891342937
Provider Name (Legal Business Name): DESTINY H TRUONG AMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2019
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 S KRAEMER BLVD STE 230
PLACENTIA CA
92870-6110
US

IV. Provider business mailing address

101 S KRAEMER BLVD STE 230
PLACENTIA CA
92870-6110
US

V. Phone/Fax

Practice location:
  • Phone: 657-215-7118
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberAMFT156540
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberAPCC20090
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: