Provider Demographics
NPI:1538628854
Name:TRAN, HOANG ANH T
Entity type:Individual
Prefix:
First Name:HOANG ANH
Middle Name:T
Last Name:TRAN
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 1:12068 SYLVAN RIV UNIT 62
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-1344
Mailing Address - Country:US
Mailing Address - Phone:714-588-0190
Mailing Address - Fax:
Practice Address - Street 1:17284 NEWHOPE ST STE 212
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-8201
Practice Address - Country:US
Practice Address - Phone:833-922-2669
Practice Address - Fax:714-509-1545
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-16
Last Update Date:2019-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23775235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist