Provider Demographics
NPI:1710228366
Name:TRUONG, JENNY V (RN)
Entity Type:Individual
Prefix:
First Name:JENNY
Middle Name:V
Last Name:TRUONG
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 1:792 W TOWN AND COUNTRY RD
Mailing Address - Street 2:BLDG. E
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-4710
Mailing Address - Country:US
Mailing Address - Phone:714-944-4033
Mailing Address - Fax:
Practice Address - Street 1:792 W TOWN AND COUNTRY RD
Practice Address - Street 2:BLDG. E
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-4710
Practice Address - Country:US
Practice Address - Phone:714-944-4033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-06
Last Update Date:2013-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8318231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical