Provider Demographics
NPI:1407296015
Name:TRUONG, ANDY (MSW)
Entity Type:Individual
Prefix:
First Name:ANDY
Middle Name:
Last Name:TRUONG
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:540 N ORANGE AVE
Mailing Address - Street 2:
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91755-1434
Mailing Address - Country:US
Mailing Address - Phone:626-510-4105
Mailing Address - Fax:
Practice Address - Street 1:540 N ORANGE AVE
Practice Address - Street 2:
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91755-1434
Practice Address - Country:US
Practice Address - Phone:626-510-4105
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-27
Last Update Date:2013-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker