Individual provider Active NPI

Jacqueline Minh Tran, FNP-BC, RN, PHN

  • Family Nurse Practitioner
  • Gilroy, CA
National Provider Identifier
1568188332
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95029084 Issued in CA
Practice address
9300 Wren Ave
Gilroy, CA 95020-7636
Phone
(408) 842-1017
NPI assigned
Oct 13, 2022
Last updated
Aug 28, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95029084 CA Primary
Registered Nurse 163W00000X 95277214 CA

Addresses

Primary practice location

9300 Wren Ave
Gilroy, CA 95020-7636

Mailing address

6840 Via del Oro Ste 210
San Jose, CA 95119-1372

Other practice location 1

416 8th St
Oakland, CA 94607-3902
Phone (519) 986-6800

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
95277214CAMDRegistered Nurse
95029084CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
School Health Clinics of Santa Clara County Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1665619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1568188332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6840 VIA DEL ORO STE 210",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951191372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9300 WREN AVE",
            "city": "GILROY",
            "state": "CA",
            "postal_code": "950207636",
            "telephone_number": "408-842-1017"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "416 8th St",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "946073902",
            "country_code": "US",
            "telephone_number": "519-986-6800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRAN",
        "first_name": "JACQUELINE",
        "middle_name": "MINH",
        "credential": "FNP-BC, RN, PHN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-13",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95029084",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95277214",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilroy, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2024; 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.