Provider Demographics
NPI:1265649685
Name:TRUONG, JILL DENISE (AS, BS)
Entity Type:Individual
Prefix:MRS
First Name:JILL
Middle Name:DENISE
Last Name:TRUONG
Suffix:
Gender:F
Credentials:AS, BS
Other - Prefix:MS
Other - First Name:JILL
Other - Middle Name:DENISE
Other - Last Name:WOODS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AS, BS
Mailing Address - Street 1:PO BOX 1000
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93302-1000
Mailing Address - Country:US
Mailing Address - Phone:661-868-6601
Mailing Address - Fax:661-868-6666
Practice Address - Street 1:2621 OSWELL ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93306-3172
Practice Address - Country:US
Practice Address - Phone:661-868-6787
Practice Address - Fax:661-868-6852
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator