Individual provider Active NPI

Lan Thi Truong, PA-C

  • Physician Assistant
  • Sacramento, CA
National Provider Identifier
1104983444
Registry record updated Jan 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA17056 Issued in CA
Practice address
3300 Stockton Blvd
Caare Center
Sacramento, CA 95820-1451
Phone
(916) 734-8396
NPI assigned
Jan 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA17056 CA Primary

Addresses

Primary practice location

3300 Stockton Blvd
Caare Center
Sacramento, CA 95820-1451

Mailing address

10725 International Dr
Dermatology
Rancho Cordova, CA 95670-7967
Phone (916) 631-3010

Other names 1

  • Cindy Truong Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE) The Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070205000144 CA Practitioner - Physician Assistant 1254333255 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA17056CAMDPhysician Assistant
17056CAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group Inc CurrentSince Oct 15, 2011 Accepting new patients
Permanente Medical Group, Inc CurrentSince Oct 15, 2011 Accepting new patients

Locations

10725 International Dr
Rncho Cordova, CA 95670
Phone (916) 631-2060

2345 Fair Oaks Blvd
Sacramento, CA 95825
Phone (916) 480-6715

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641859200000",
    "number": "1104983444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10725 INTERNATIONAL DR",
            "address_2": "DERMATOLOGY",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956707967",
            "telephone_number": "916-631-3010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 STOCKTON BLVD",
            "address_2": "CAARE CENTER",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958201451",
            "telephone_number": "916-734-8396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUONG",
        "first_name": "LAN",
        "middle_name": "THI",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-03",
        "last_updated": "2022-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA17056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "2345 Fair Oaks Blvd",
            "city": "Sacramento",
            "state": "CA",
            "country_code": "US",
            "postal_code": "958254708",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CINDY",
            "last_name": "TRUONG",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.