MEDICARE: JASMINE-NICOLE TRAN PMHNP-BC

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
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	95037475	CA
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	95188410	CA

General Provider Information

NPI Number	:	1679449359
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASMINE-NICOLE TRAN PMHNP-BC

Provider Business Mailing Address
First Line	:	200 FREEDOM LN
Second Line	:
City	:	ALISO VIEJO
State	:	CA
Zip	:	92656-5876
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	17290 NEWHOPE ST STE B
Second Line	:
City	:	FOUNTAIN VALLEY
State	:	CA
Zip	:	92708-8205
Country	:	US
Telephone Number	:	949-522-1469
Fax Number	:	714-455-7074

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/11/2025
Last Update Date	:	06/15/2026

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