Individual provider Active NPI

Stacy Y Truong

  • Other Technician
  • Orange, CA
National Provider Identifier
1023693934
Registry record updated Mar 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Other TechnicianTaxonomy code 247200000X
Practice address
1820 W Orangewood Ave Ste 110
Orange, CA 92868-5056
Phone
(714) 696-2862
NPI assigned
Mar 11, 2021
Last updated
Mar 11, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Other Technician 247200000X Primary

Addresses

Primary practice location

1820 W Orangewood Ave Ste 110
Orange, CA 92868-5056

Mailing address

1820 W Orangewood Ave Ste 110
Orange, CA 92868-5056
Phone (714) 696-2862

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251105004439 CA Practitioner - Physical Therapist in Private Practice 1052801305 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2777 Bristol St
Suite B
Costa Mesa, CA 92626-5997
Phone (949) 250-1112

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Prosport Physical Therapy Professionals Inc Current Accepting new patients
Prosport Physical Therapy Professionals Inc CurrentSince Aug 11, 2025 Accepting new patients

Locations

2777 Bristol St
Ste B
Costa Mesa, CA 92626
Phone (949) 250-1112

26672 Portola Pkwy
Ste 116
Foothill Rnch, CA 92610
Phone (714) 450-4999

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1615420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615420800000",
    "number": "1023693934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1820 W ORANGEWOOD AVE STE 110",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928685056",
            "telephone_number": "714-696-2862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1820 W ORANGEWOOD AVE STE 110",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928685056",
            "telephone_number": "714-696-2862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUONG",
        "first_name": "STACY",
        "middle_name": "Y",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-11",
        "last_updated": "2021-03-11",
        "certification_date": "2021-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247200000X",
            "taxonomy_group": "",
            "desc": "Technician, Other",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.