Healthcare Provider Details

I. General information

NPI: 1841922473
Provider Name (Legal Business Name): KHANH TRAN LE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2022
Last Update Date: 09/11/2023
Certification Date: 09/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1887 MONTEREY HWY STE 205
SAN JOSE CA
95112-6192
US

IV. Provider business mailing address

1887 MONTEREY HWY STE 205
SAN JOSE CA
95112-6192
US

V. Phone/Fax

Practice location:
  • Phone: 408-961-4040
  • Fax:
Mailing address:
  • Phone: 650-390-7169
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: