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General NPI Number Information
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NPI Number | 1174205785
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Entity Type | Individual
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Provider Name | DARRENCE TRAN
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Gender | Male
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Dates
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Enumeration Date | 08/02/2023
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Last Update Date | 08/03/2023
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Provider Practice Location Address
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Address Line | 1855 ALUM ROCK AVE STE C
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City | SAN JOSE
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State | CA
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Zip | 95116-1398
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Country | US
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Telephone | 408-254-7524
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Fax |
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Provider Business Mailing Address
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Address Line | 1925 WONDERAMA DR
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City | SAN JOSE
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State | CA
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Zip | 95148-1132
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Country | US
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Telephone | 408-901-9534
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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 | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State | CA
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