Healthcare Provider Details

I. General information

NPI: 1508788340
Provider Name (Legal Business Name): CAM VAN HOAI TRAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2026
Last Update Date: 07/25/2026
Certification Date: 07/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 JOSE FIGUERES AVE STE 380
SAN JOSE CA
95116-1591
US

IV. Provider business mailing address

200 JOSE FIGUERES AVE STE 380
SAN JOSE CA
95116-1591
US

V. Phone/Fax

Practice location:
  • Phone: 408-259-0737
  • Fax: 408-259-0649
Mailing address:
  • Phone: 408-259-0737
  • Fax: 408-259-0649

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95040596
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: