Provider Demographics
NPI:1124128335
Name:TRAN, YVONNE THOA (MS, MFT)
Entity type:Individual
Prefix:MRS
First Name:YVONNE
Middle Name:THOA
Last Name:TRAN
Suffix:
Gender:F
Credentials:MS, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1627 S HARGRAVE ST
Mailing Address - Street 2:
Mailing Address - City:BANNING
Mailing Address - State:CA
Mailing Address - Zip Code:92220-6169
Mailing Address - Country:US
Mailing Address - Phone:714-360-4058
Mailing Address - Fax:951-922-7752
Practice Address - Street 1:1627 S HARGRAVE ST
Practice Address - Street 2:
Practice Address - City:BANNING
Practice Address - State:CA
Practice Address - Zip Code:92220-6169
Practice Address - Country:US
Practice Address - Phone:951-922-7820
Practice Address - Fax:951-922-7752
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF46851106H00000X
CAMFC 49892106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist