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General NPI Number Information
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NPI Number | 1114310372
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Entity Type | Individual
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Provider Name | MICHELLE THUSINH TRAN CPNP
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Gender | Female
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Dates
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Enumeration Date | 03/12/2015
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Last Update Date | 05/05/2017
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Provider Practice Location Address
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Address Line | 2650 S BRISTOL ST SUITE 101
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City | SANTA ANA
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State | CA
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Zip | 92704-5751
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Country | US
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Telephone | 714-754-1444
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Fax |
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Provider Business Mailing Address
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Address Line | 821 S WEBSTER AVE APT 6
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City | ANAHEIM
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State | CA
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Zip | 92804-4171
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Country | US
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Telephone | 510-828-6542
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 95002067
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License Number State | CA
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