Provider Demographics
NPI:1578089694
Name:TRAN, ALICE (BS, PTA, CBIS)
Entity Type:Individual
Prefix:MRS
First Name:ALICE
Middle Name:
Last Name:TRAN
Suffix:
Gender:F
Credentials:BS, PTA, CBIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7601 E. IMPERIAL HWY.
Mailing Address - Street 2:JPI BUILDING, RM 1160
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90242
Mailing Address - Country:US
Mailing Address - Phone:562-385-6237
Mailing Address - Fax:
Practice Address - Street 1:7601 E. IMPERIAL HWY.
Practice Address - Street 2:JPI BUILDING, RM 1160
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90242
Practice Address - Country:US
Practice Address - Phone:562-385-6237
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPTA6142225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant