Healthcare Provider Details

I. General information

NPI: 1184070294
Provider Name (Legal Business Name): HOANG TRAN M.S. CCC-SLP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2016
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1415 FAIRHAVEN AVE
SANTA ANA CA
92705-6822
US

IV. Provider business mailing address

8782 DUDMAN DR
GARDEN GROVE CA
92841-3266
US

V. Phone/Fax

Practice location:
  • Phone: 714-997-6178
  • Fax:
Mailing address:
  • Phone: 714-260-3350
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number24613
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: