Provider Demographics
NPI:1003101726
Name:TRIEU, VIVIEN CHAN (NP)
Entity type:Individual
Prefix:
First Name:VIVIEN
Middle Name:CHAN
Last Name:TRIEU
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1917 EDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91803-2920
Mailing Address - Country:US
Mailing Address - Phone:626-203-8889
Mailing Address - Fax:
Practice Address - Street 1:1917 EDGEWOOD DR
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91803-2920
Practice Address - Country:US
Practice Address - Phone:626-203-8889
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-10
Last Update Date:2011-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP 19800363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily