Basic Information
| Provider Information | |||||||||
| NPI: | 1285280685 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TRAN | ||||||||
| FirstName: | LINH | ||||||||
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| Credential: | PMHNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 333 1ST ST APT F307 | ||||||||
| Address2: | |||||||||
| City: | SEAL BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 907405949 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 4500 E PACIFIC COAST HWY STE 320 | ||||||||
| Address2: | |||||||||
| City: | LONG BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 908043271 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4242842440 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/13/2019 | ||||||||
| LastUpdateDate: | 03/23/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/16/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WP0807X | 741184-1 | NY | N | Nursing Service Providers | Registered Nurse | Psych/Mental Health, Child & Adolescent | 363LP0808X | 402993 | NY | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health | 363LP0808X | 95018807 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
ID Information
| ID | Type | State | Issuer | Description | 741184-1 | 01 | NY | REGISTERED NURSE | OTHER |