Individual provider Active NPI

Ky My Trieu

  • Student in an Organized Health Care Education/Training Program
  • San Lorenzo, CA
National Provider Identifier
1174498877
Registry record updated Oct 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
17576 Via Segundo
San Lorenzo, CA 94580-3242
Phone
(510) 502-5676
NPI assigned
Oct 10, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

17576 Via Segundo
San Lorenzo, CA 94580-3242

Mailing address

17576 Via Segundo
San Lorenzo, CA 94580-3242

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1760054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760054400000",
    "number": "1174498877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17576 VIA SEGUNDO",
            "city": "SAN LORENZO",
            "state": "CA",
            "postal_code": "945803242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17576 VIA SEGUNDO",
            "city": "SAN LORENZO",
            "state": "CA",
            "postal_code": "945803242",
            "telephone_number": "510-502-5676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRIEU",
        "first_name": "KY",
        "middle_name": "MY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-10",
        "last_updated": "2025-10-10",
        "certification_date": "2025-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Lorenzo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.