Provider Demographics
NPI:1003600594
Name:NGUYEN, JULIE TRAN
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:TRAN
Last Name:NGUYEN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9416 EL VALLE AVE
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-4535
Mailing Address - Country:US
Mailing Address - Phone:714-675-2608
Mailing Address - Fax:
Practice Address - Street 1:701 W KIMBERLY AVE
Practice Address - Street 2:
Practice Address - City:PLACENTIA
Practice Address - State:CA
Practice Address - Zip Code:92870-6342
Practice Address - Country:US
Practice Address - Phone:714-203-6595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-08
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician