Healthcare Provider Details

I. General information

NPI: 1225379803
Provider Name (Legal Business Name): JENNIFER TRINH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2013
Last Update Date: 02/26/2026
Certification Date: 02/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1691 GALISTEO ST STE D
SANTA FE NM
87505-4781
US

IV. Provider business mailing address

45 CAMINO QUIEN SABE
SANTA FE NM
87505-8156
US

V. Phone/Fax

Practice location:
  • Phone: 505-955-9454
  • Fax: 505-982-0279
Mailing address:
  • Phone: 505-955-9454
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number25MA09270200
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: