Provider Demographics
NPI:1518294818
Name:TRUONG, DIANA
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:TRUONG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8840 COSTA VERDE BLVD
Mailing Address - Street 2:#3333
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92122-6622
Mailing Address - Country:US
Mailing Address - Phone:408-889-3777
Mailing Address - Fax:
Practice Address - Street 1:8745 AERO DR
Practice Address - Street 2:SUITE 330
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-1761
Practice Address - Country:US
Practice Address - Phone:858-268-4933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-06
Last Update Date:2009-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator