Healthcare Provider Details

I. General information

NPI: 1548634520
Provider Name (Legal Business Name): JENNIFER TRAN NP, CNS, MSN, PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/13/2015
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

147 W SIERRA MADRE BLVD
SIERRA MADRE CA
91024-2492
US

IV. Provider business mailing address

20054 HAWTHORNE BLVD
TORRANCE CA
90503-1518
US

V. Phone/Fax

Practice location:
  • Phone: 626-355-3443
  • Fax: 626-355-7843
Mailing address:
  • Phone: 626-355-3443
  • Fax: 626-355-7843

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License Number4202
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95003271
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number811320
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: