Provider Demographics
NPI:1154670891
Name:TRAN, ANTHONY-HUNG CASTILLO (LCSW)
Entity Type:Individual
Prefix:
First Name:ANTHONY-HUNG
Middle Name:CASTILLO
Last Name:TRAN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142 N MILPITAS BLVD STE 245
Mailing Address - Street 2:
Mailing Address - City:MILPITAS
Mailing Address - State:CA
Mailing Address - Zip Code:95035-4401
Mailing Address - Country:US
Mailing Address - Phone:408-461-6166
Mailing Address - Fax:
Practice Address - Street 1:2500 GRANT RD,
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040
Practice Address - Country:US
Practice Address - Phone:408-461-6166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-07
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CA875731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA74263OtherACSW REGISTRATION
CA74263OtherACSW REGISTRATION