Provider Demographics
NPI:1710759683
Name:TRAN, JENNIFER BAO-CHAU (PHARMD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:BAO-CHAU
Last Name:TRAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2979 CASTLETON DR
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95148-3005
Mailing Address - Country:US
Mailing Address - Phone:408-600-8911
Mailing Address - Fax:
Practice Address - Street 1:2979 CASTLETON DR
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95148-3005
Practice Address - Country:US
Practice Address - Phone:408-600-8911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-24
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA88719183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist