| Stanly Tran, LCSW | |
|
3540 Howard Way Ste 150, Costa Mesa, CA 92626-1496 | |
| (949) 646-9227 | |
| Not Available |
| Full Name | Stanly Tran |
|---|---|
| Gender | Male |
| Speciality | Social Worker - Clinical |
| Location | 3540 Howard Way Ste 150, Costa Mesa, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134556137 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | 80129 (California) | Primary |
| Entity Name | Providence Medical Foundation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1285890624 PECOS PAC ID: 8921993205 Enrollment ID: O20040216001346 |
| Mailing Address | Practice Location Address |
|---|---|
| Stanly Tran, LCSW 1095 Irvine Blvd, Tustin, CA 92780-3526 Ph: () - | Stanly Tran, LCSW 3540 Howard Way Ste 150, Costa Mesa, CA 92626-1496 Ph: (949) 646-9227 |
Michelle Elaine Glinski, MSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2801 Bristol St, Costa Mesa, CA 92626 Phone: 714-850-8410 | |
Joseph Madrid, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 252 16th Pl Apt C, Costa Mesa, CA 92627 Phone: 949-566-5222 | |
Shelley Beckham, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 271 Mesa Dr, Costa Mesa, CA 92627 Phone: 949-422-1882 Fax: 949-548-2303 | |
Brian Jacobo, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 301 Victoria St, Costa Mesa, CA 92627 Phone: 949-642-2734 | |
Jeremy Quang Le, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 301 Victoria St, Costa Mesa, CA 92627 Phone: 949-642-2734 | |
Lizeth Dimas Sebastian, Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 2801 Bristol St, Costa Mesa, CA 92626 Phone: 714-850-8408 | |
Kelleen Carrie Stainer, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 555 Anton Blvd Ste 150, Costa Mesa, CA 92626 Phone: 949-204-0011 |