Provider Demographics
NPI:1316732357
Name:TRAN, KATHY LONG THIEN
Entity type:Individual
Prefix:
First Name:KATHY
Middle Name:LONG THIEN
Last Name:TRAN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2683 KEPPLER DR
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95148-2508
Mailing Address - Country:US
Mailing Address - Phone:408-417-9887
Mailing Address - Fax:
Practice Address - Street 1:2683 KEPPLER DR
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95148-2508
Practice Address - Country:US
Practice Address - Phone:408-417-9887
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-10
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant