Provider Demographics
NPI:1215968078
Name:TRAN, PHUONG THUY THI (PSYD)
Entity type:Individual
Prefix:DR
First Name:PHUONG THUY
Middle Name:THI
Last Name:TRAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7012 HAWAII KAI DR
Mailing Address - Street 2:#602
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96825-3112
Mailing Address - Country:US
Mailing Address - Phone:808-396-3505
Mailing Address - Fax:
Practice Address - Street 1:55 MERCHANT ST
Practice Address - Street 2:22ND FLOOR
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-4306
Practice Address - Country:US
Practice Address - Phone:808-535-7619
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPSY 939103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical