Healthcare Provider Details

I. General information

NPI: 1801705256
Provider Name (Legal Business Name): PHUONG-VY HOANG TRAN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6641 STANFORD RANCH RD
ROCKLIN CA
95677-2674
US

IV. Provider business mailing address

6641 STANFORD RANCH RD
ROCKLIN CA
95677-2674
US

V. Phone/Fax

Practice location:
  • Phone: 916-229-8175
  • Fax:
Mailing address:
  • Phone: 916-892-6324
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA68864
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: