Provider Demographics
NPI:1972798098
Name:TRUONG, DONNA (PSYD)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:TRUONG
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3031 S VERMONT AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90007-3033
Mailing Address - Country:US
Mailing Address - Phone:323-766-2360
Mailing Address - Fax:323-373-2442
Practice Address - Street 1:23822 VALENCIA BLVD STE 207
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-5348
Practice Address - Country:US
Practice Address - Phone:661-437-3287
Practice Address - Fax:661-244-3513
Is Sole Proprietor?:No
Enumeration Date:2007-09-11
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPSYD30689103TC0700X
225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner