Healthcare Provider Details

I. General information

NPI: 1326686718
Provider Name (Legal Business Name): LILLIAN TRAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2019
Last Update Date: 12/27/2019
Certification Date: 12/27/2019
Deactivation Date: 12/16/2019
Reactivation Date: 12/27/2019

III. Provider practice location address

660 S FAIR OAKS AVE
SUNNYVALE CA
94086-7913
US

IV. Provider business mailing address

660 S FAIR OAKS AVE
SUNNYVALE CA
94086-7913
US

V. Phone/Fax

Practice location:
  • Phone: 408-992-4920
  • Fax:
Mailing address:
  • Phone: 408-992-4920
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number95158656
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: