Healthcare Provider Details

I. General information

NPI: 1174101422
Provider Name (Legal Business Name): BRIAN TRAN PMHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2021
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20098 ASHBROOK PL STE 255
ASHBURN VA
20147-3394
US

IV. Provider business mailing address

20098 ASHBROOK PL STE 255
ASHBURN VA
20147-3394
US

V. Phone/Fax

Practice location:
  • Phone: 844-863-4621
  • Fax: 844-447-3352
Mailing address:
  • Phone: 844-863-4621
  • Fax: 844-447-3352

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number0001307548
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0024191627
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: