Provider Demographics
NPI:1770136582
Name:TRUONG, LINDA
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:TRUONG
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 1:4920 W 1ST ST APT 48
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92703-5102
Mailing Address - Country:US
Mailing Address - Phone:714-775-8043
Mailing Address - Fax:
Practice Address - Street 1:711 E BALL RD STE 201
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92805-5925
Practice Address - Country:US
Practice Address - Phone:714-254-8473
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-20
Last Update Date:2019-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist