Healthcare Provider Details

I. General information

NPI: 1720945017
Provider Name (Legal Business Name): DEANNE TRAN MS., QASP-S
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/07/2026
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19019 VENTURA BLVD
TARZANA CA
91356-3253
US

IV. Provider business mailing address

19019 VENTURA BLVD
TARZANA CA
91356-3253
US

V. Phone/Fax

Practice location:
  • Phone: 818-501-8352
  • Fax:
Mailing address:
  • Phone: 818-501-8352
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number16293
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: