Healthcare Provider Details

I. General information

NPI: 1376370965
Provider Name (Legal Business Name): TERESA TRINH RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2024
Last Update Date: 09/17/2024
Certification Date: 09/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12945 SARATOGA AVE
SARATOGA CA
95070-4131
US

IV. Provider business mailing address

6290 GUNTER WAY
SAN JOSE CA
95123-4620
US

V. Phone/Fax

Practice location:
  • Phone: 408-893-6364
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License Number95216540
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WX0003X
TaxonomyInpatient Obstetric Registered Nurse
License Number95216540
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code163WS0121X
TaxonomyPlastic Surgery Registered Nurse
License Number95216540
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: