Provider Demographics
NPI:1568188332
Name:TRAN, JACQUELINE MINH (RN)
Entity Type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:MINH
Last Name:TRAN
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 1:101 8TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94607-4707
Mailing Address - Country:US
Mailing Address - Phone:510-986-6800
Mailing Address - Fax:
Practice Address - Street 1:416 8TH ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94607-3902
Practice Address - Country:US
Practice Address - Phone:519-986-6800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-13
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95277214163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse