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General NPI Number Information
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NPI Number | 1013708569
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Entity Type | Individual
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Provider Name | VIVIAN TRUONG
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Gender | Female
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Dates
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Enumeration Date | 05/14/2025
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Last Update Date | 05/14/2025
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Provider Practice Location Address
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Address Line | 501 LIGHTHOUSE AVE
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City | MONTEREY
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State | CA
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Zip | 93940-1439
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Country | US
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Telephone | 831-649-0770
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Fax |
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Provider Business Mailing Address
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Address Line | 3179 NAPA DR
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City | SAN JOSE
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State | CA
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Zip | 95148-2027
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Country | US
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Telephone | 408-912-0496
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State | CA
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