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NPI Code Detail

MEDICARE: DANG NGUYEN TRINH

MEDICARE: DANG NGUYEN TRINH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1417451550
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANG NGUYEN TRINH
Provider Business Mailing Address
First Line : 3103 JENKINS AVE
Second Line :
City : SAN JOSE
State : CA
Zip : 95118-1413
Country : US
Telephone Number : 408-759-0010
Fax Number :
Provider Business Practice Location Address
First Line : 1500 E HAMILTON AVE STE 105
Second Line :
City : CAMPBELL
State : CA
Zip : 95008-0834
Country : US
Telephone Number : 408-772-3775
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/22/2018
Last Update Date : 03/22/2018

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Directions to “ DANG NGUYEN TRINH ” Practice Location

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