Active NPI
Phuong Thi Hai Tran, PHARMD
- Pharmacist
- Antioch, CA
National Provider Identifier
1235614413
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 79501
- Practice address
- 3365 Deer Valley Rd
Antioch, CA 94531-6664 - Phone
- (925) 706-4152
- NPI assigned
- Oct 3, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 79501 | CA | Primary |
Addresses
Primary practice location
3365 Deer Valley Rd
Antioch, CA 94531-6664
Mailing address
3365 Deer Valley Rd
Antioch, CA 94531-6664
Other practice location 1
4309 Clayton Rd
Concord, CA 94521-2842
Phone (925) 356-2712
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 79501 | Other | CA | CALIFORNIA BOARD OF PHARMACY |
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 79501 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Safeway Inc | Community/Retail Pharmacy | Past | Accepting new patients |
| Safeway Inc | Community/Retail Pharmacy | Past | Accepting new patients |
| Safeway Inc | Community/Retail Pharmacy | Past | Accepting new patients |
Organizations & group practices 3
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": "1538524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600214400000",
"number": "1235614413",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3365 DEER VALLEY RD",
"city": "ANTIOCH",
"state": "CA",
"postal_code": "945316664"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3365 DEER VALLEY RD",
"city": "ANTIOCH",
"state": "CA",
"postal_code": "945316664",
"telephone_number": "925-706-4152"
}
],
"practiceLocations": [
{
"address_1": "4309 Clayton Rd",
"address_purpose": "LOCATION",
"city": "Concord",
"state": "CA",
"postal_code": "945212842",
"country_code": "US",
"telephone_number": "925-356-2712",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TRAN",
"first_name": "PHUONG",
"middle_name": "THI HAI",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-10-03",
"last_updated": "2020-09-16",
"certification_date": "2020-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "79501",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CALIFORNIA BOARD OF PHARMACY",
"identifier": "79501",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Antioch, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.