Provider Demographics
NPI:1316192594
Name:CHAN, YEN DUYEN NGOC TRAN (ND)
Entity Type:Individual
Prefix:DR
First Name:YEN
Middle Name:DUYEN NGOC TRAN
Last Name:CHAN
Suffix:
Gender:F
Credentials:ND
Other - Prefix:DR
Other - First Name:YEN
Other - Middle Name:
Other - Last Name:TRAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ND
Mailing Address - Street 1:5595 WINFIELD BLVD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95123-1220
Mailing Address - Country:US
Mailing Address - Phone:408-792-7229
Mailing Address - Fax:408-706-5588
Practice Address - Street 1:5595 WINFIELD BLVE
Practice Address - Street 2:SUITE 106
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95123
Practice Address - Country:US
Practice Address - Phone:408-792-7229
Practice Address - Fax:408-706-5588
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-01
Last Update Date:2015-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAND-333175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath