Individual provider Active NPI

Jennifer Diem Truong, RNP

  • Nurse Practitioner
  • Costa Mesa, CA
National Provider Identifier
1194777045
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
495905 Issued in CA
Practice address
2501 Harbor Blvd
Costa Mesa, CA 92626-6143
Phone
(714) 957-5000
NPI assigned
May 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 495905 CA Primary

Addresses

Primary practice location

2501 Harbor Blvd
Costa Mesa, CA 92626-6143

Mailing address

1600 9TH Street
Room 205 Mailstop 2 3
Sacramento, CA 95814-6414
Phone (916) 654-2431

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
I20040506000708 CA Practitioner - Nurse Practitioner 4284623273 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Department of State HospitalsGroup PAC ID 9638174238, 275 clinicians

Practice addresses (Care Compare)

11401 Bloomfield Ave
Norwalk, CA 90650-2015
Phone (916) 651-8811

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
10357CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Agnews Community Clinic CurrentSince May 23, 2007 Accepting new patients
State of California - Department of Developmental Services Current Accepting new patients
State of California - Department of Developmental Services CurrentSince May 23, 2007 Accepting new patients
Department of State Hospitals Current Accepting new patients
Department of State Hospitals CurrentSince Jan 26, 2020 Accepting new patients
Department of State Hospitals CurrentSince Jan 26, 2020 Accepting new patients
State of California - Department of Developmental Services Past Accepting new patients

Locations

2501 Harbor Blvd
Costa Mesa, CA 92626
Phone (714) 957-5000

11401 Bloomfield Ave
Norwalk, CA 90650
Phone (562) 863-7011

26501 Avenue 140
Porterville, CA 93257
Phone (559) 782-2222

1215 O St
#3
Sacramento, CA 95814
Phone (916) 651-2805

1600 9th St
Ste 150
Sacramento, CA 95814
Phone (916) 651-8811

Organizations & group practices 7

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": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1194777045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 9TH STREET",
            "address_2": "ROOM 205 MAILSTOP 2 3",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958146414",
            "telephone_number": "916-654-2431",
            "fax_number": "916-654-3186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 HARBOR BLVD",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926266143",
            "telephone_number": "714-957-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUONG",
        "first_name": "JENNIFER",
        "middle_name": "DIEM",
        "name_prefix": "Mrs.",
        "credential": "RNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-17",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "495905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Costa Mesa, CA

Sources for this page

Verify at the official NPI Registry.