Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | ||
N | 101YM0800X | Mental Health Counselor | ||
Y | 170100000X | Medical Geneticist |
NPI | 1629593652 |
---|---|
Provider Name | Dr. Lee Tran |
First Address | Vallejo, CA 94590-5905 |
Second Address | Walnut Creek, CA 94597-1833 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2017 |
Last Update Date | 14/02/2020 |