Provider Demographics
NPI:1376632315
Name:TRAN, THOA KIM THI (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:THOA
Middle Name:KIM THI
Last Name:TRAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:594 N GLASSELL ST
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92867-6748
Mailing Address - Country:US
Mailing Address - Phone:714-200-7636
Mailing Address - Fax:
Practice Address - Street 1:12912 BROOKHURST ST STE 480
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92840-4867
Practice Address - Country:US
Practice Address - Phone:714-200-7636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 208421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical