Healthcare Provider Details

I. General information

NPI: 1871956847
Provider Name (Legal Business Name): TRANG DOAN NGUYEN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2016
Last Update Date: 08/15/2023
Certification Date: 08/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2275 ARLINGTON DR
SAN LEANDRO CA
94578-1132
US

IV. Provider business mailing address

700 ADELINE ST
OAKLAND CA
94607-2608
US

V. Phone/Fax

Practice location:
  • Phone: 510-317-1444
  • Fax:
Mailing address:
  • Phone: 510-835-9610
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95044705
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Registered Nurse
License Number95044705
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95025868
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: