| Doctor Name: | JEANNIE NGOC-THAO TRAN |
| NPI Number: | 1437549995 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 0203014670 |
| Business Practice Address: | 2905 District Ave Ste 400 Fairfax, VA - 220312278 |
| Business Phone Number: | 5715333751 |
| Business Fax Number: | |
| Mailing Address: | 2828 New Providence Ct, FALLS CHURCH |
| State: | VA |
| Postal Code: | 220424432 |
| Phone Number: | 5712499823 |
| Fax Number: | |
| NPI Enumeration Date: | 02/04/2015 |
| NPI Last Update Date: | 02/04/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 390200000X |
| License Number: | 0203014670 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Student, Health Care |
| Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |