Provider Demographics
NPI:1407232457
Name:VANG, TRONG (RN)
Entity Type:Individual
Prefix:
First Name:TRONG
Middle Name:
Last Name:VANG
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4879 E KINGS CANYON RD
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93727-3811
Mailing Address - Country:US
Mailing Address - Phone:559-255-8395
Mailing Address - Fax:
Practice Address - Street 1:4855 E KINGS CANYON RD
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93727-3811
Practice Address - Country:US
Practice Address - Phone:559-255-8395
Practice Address - Fax:559-255-1690
Is Sole Proprietor?:No
Enumeration Date:2015-07-31
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95067353163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health