Provider Demographics
NPI:1578199907
Name:TRUONG, JADE THI
Entity Type:Individual
Prefix:
First Name:JADE
Middle Name:THI
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 1:295 STAGEHAND DR
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95111-2840
Mailing Address - Country:US
Mailing Address - Phone:669-350-7997
Mailing Address - Fax:
Practice Address - Street 1:950 S BASCOM AVE STE 2010
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-3538
Practice Address - Country:US
Practice Address - Phone:408-341-9222
Practice Address - Fax:408-645-5540
Is Sole Proprietor?:No
Enumeration Date:2020-03-17
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other