Individual provider Active NPI

Kelly Thao Tran, NP

  • Women's Health Nurse Practitioner
  • Garden Grove, CA
National Provider Identifier
1255799276
Registry record updated Jun 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
NP95003689 Issued in CA
Practice address
12032 Fairchild St
Garden Grove, CA 92845-1529
Phone
(714) 249-5050
NPI assigned
Feb 4, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X NP95003689 CA Primary
Registered Nurse 163W00000X 770299 CA

Addresses

Primary practice location

12032 Fairchild St
Garden Grove, CA 92845-1529

Mailing address

12032 Fairchild St
Garden Grove, CA 92845-1529
Phone (714) 249-5050

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://memorialcare.org/fhir/api/FHIR/R4/ Health Information Exchange (HIE) MemorialCare Medical Foundation

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
I20200213002934 CA Practitioner - Nurse Practitioner 3375979107 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorialcare Medical FoundationGroup PAC ID 8729277314, 555 clinicians
Family Health Centers of San Diego IncGroup PAC ID 3476446378, 299 clinicians

Practice addresses (Care Compare)

18035 Brookhurst St
Suite 2100
Fountain Valley, CA 92708-6738
Phone (657) 241-9090

3514 30TH St
San Diego, CA 92104-4120
Phone (619) 515-2424

3544 30TH St
San Diego, CA 92104-4120
Phone (619) 515-2424

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
770299CAMDRegistered Nurse
NP95003689CAMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Centers of San Diego, Inc CurrentSince Mar 9, 2021 Accepting new patients
Family Health Centers of San Diego, Inc. CurrentSince Mar 9, 2021 Accepting new patients
Memorialcare Medical Foundation CurrentSince Feb 1, 2020 Accepting new patients
Family Health Centers of San Diego, Inc Current Accepting new patients
Allara Medical Group PA Past Accepting new patients

Locations

722 Baker St
Costa Mesa, CA 92626
Phone (714) 557-6300

18035 Brookhurst St
Ste 2100
Fountain Valley, CA 92708
Phone (657) 241-9090

17360 Brookhurst St
Fountain Vly, CA 92708
Phone (657) 241-3592

3828 Schaufele Ave
Ste 200
Long Beach, CA 90808
Phone (657) 241-8990

1809 National Ave
San Diego, CA 92113
Phone (619) 515-2500

823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323

Interoperability endpoints

  • Direct secure messaging: tran.thao.p1@direct.scfhc.nextgenshare.com

Organizations & group practices 5

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": "1454544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781222400000",
    "number": "1255799276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12032 FAIRCHILD ST",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928451529",
            "telephone_number": "714-249-5050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12032 FAIRCHILD ST",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928451529",
            "telephone_number": "714-249-5050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "KELLY",
        "middle_name": "THAO",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-04",
        "last_updated": "2026-06-12",
        "certification_date": "2026-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "CA",
            "license": "NP95003689",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "770299",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://memorialcare.org/fhir/api/FHIR/R4/",
            "affiliation": "Y",
            "endpointDescription": "MemorialCare FHIR Endpoint",
            "affiliationName": "MemorialCare Medical Foundation",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "17360 Brookhurst St",
            "city": "Fountain Valley",
            "state": "CA",
            "country_code": "US",
            "postal_code": "927083720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

Verify at the official NPI Registry.