Provider Demographics
NPI:1346894524
Name:TRAN, AMY LE
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:LE
Last Name:TRAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MEKONG COMMUNITY CENTER
Mailing Address - Street 2:2203 TULLY ROAD
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95122
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:MEKONG COMMUNITY CENTER
Practice Address - Street 2:2203 TULLY ROAD
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95122
Practice Address - Country:US
Practice Address - Phone:408-937-1553
Practice Address - Fax:408-937-1548
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-26
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator