Provider Demographics
NPI:1447931415
Name:TRAN, TIMOTHY KHAI-TRI
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:KHAI-TRI
Last Name:TRAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1146 E SUNFLOWER CIR
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92866-3372
Mailing Address - Country:US
Mailing Address - Phone:714-222-6957
Mailing Address - Fax:
Practice Address - Street 1:1146 E SUNFLOWER CIR
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92866-3372
Practice Address - Country:US
Practice Address - Phone:714-222-6957
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-31
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician