Healthcare Provider Details

I. General information

NPI: 1063358810
Provider Name (Legal Business Name): SHAWNA TRAN
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2026
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2290 N 1ST ST STE 101
SAN JOSE CA
95131-2017
US

IV. Provider business mailing address

PO BOX 731012
SAN JOSE CA
95173-1012
US

V. Phone/Fax

Practice location:
  • Phone: 408-882-1717
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: