Provider Demographics
NPI:1902175813
Name:TRUONG, HONG NHUNG THI
Entity Type:Individual
Prefix:
First Name:HONG NHUNG
Middle Name:THI
Last Name:TRUONG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10515 BALBOA BLVD
Mailing Address - Street 2:SUITE 376
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344-6343
Mailing Address - Country:US
Mailing Address - Phone:818-488-3837
Mailing Address - Fax:
Practice Address - Street 1:10515 BALBOA BLVD
Practice Address - Street 2:SUITE 376
Practice Address - City:GRANADA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91344-6343
Practice Address - Country:US
Practice Address - Phone:818-488-3837
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-21
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA792226101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health