Provider Demographics
NPI:1215523246
Name:TO, TRINH TU (LVN)
Entity type:Individual
Prefix:MS
First Name:TRINH
Middle Name:TU
Last Name:TO
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 S ELECTRIC AVE APT A
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-3177
Mailing Address - Country:US
Mailing Address - Phone:626-383-5283
Mailing Address - Fax:
Practice Address - Street 1:3244 E GREEN ST
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91107-3836
Practice Address - Country:US
Practice Address - Phone:626-844-3033
Practice Address - Fax:626-449-9128
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-14
Last Update Date:2020-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA711235164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse