Provider Demographics
NPI:1417451550
Name:TRINH, DANG NGUYEN
Entity Type:Individual
Prefix:
First Name:DANG
Middle Name:NGUYEN
Last Name:TRINH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3103 JENKINS AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95118-1413
Mailing Address - Country:US
Mailing Address - Phone:408-759-0010
Mailing Address - Fax:
Practice Address - Street 1:1500 E HAMILTON AVE STE 105
Practice Address - Street 2:
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008-0834
Practice Address - Country:US
Practice Address - Phone:408-772-3775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-22
Last Update Date:2018-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician