Provider Demographics
NPI:1356641054
Name:VAN, DARLENE TRAN (DC)
Entity Type:Individual
Prefix:DR
First Name:DARLENE
Middle Name:TRAN
Last Name:VAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:DIEM-HA
Other - Middle Name:TRAN
Other - Last Name:VAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:415 GWINN CT
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95111-1725
Mailing Address - Country:US
Mailing Address - Phone:408-623-3208
Mailing Address - Fax:
Practice Address - Street 1:2381 SENTER RD
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95112-2610
Practice Address - Country:US
Practice Address - Phone:408-623-3208
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-27
Last Update Date:2010-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31711111NI0013X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0013XChiropractic ProvidersChiropractorIndependent Medical Examiner