Provider Demographics
NPI:1871199083
Name:HA, ANH TRAN
Entity Type:Individual
Prefix:
First Name:ANH
Middle Name:TRAN
Last Name:HA
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 1:5301 SANDSTONE ST
Mailing Address - Street 2:
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608-0625
Mailing Address - Country:US
Mailing Address - Phone:916-230-8289
Mailing Address - Fax:
Practice Address - Street 1:5901 VALLEJO ST
Practice Address - Street 2:
Practice Address - City:EMERYVILLE
Practice Address - State:CA
Practice Address - Zip Code:94608-2136
Practice Address - Country:US
Practice Address - Phone:949-922-9562
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-11
Last Update Date:2020-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA781926163WG0000X, 163WX0200X
CA95012927363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163WX0200XNursing Service ProvidersRegistered NurseOncology