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Provider Information for 1053799858


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LISA TRAN


Sex: Female

NPI: 1053799858
Last Updated: 2015-05-12
Certification Date:

Details

NameValue
NPI1053799858
Enumeration Date2015-05-12
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 8836 SYCAMORE AVE
WESTMINSTER, CA 92683-5497
United States

Phone: 714-260-8571 | Fax:
 
Primary Practice Address 1200 N MAIN ST
SANTA ANA, CA 92701-3640
United States

Phone: 714-480-4678 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 106H00000X - Marriage & Family Therapist CAIMF81431