Individual ProviderKhadeja TranSocial WorkerBehavioral Health & Social Service ProvidersPractice Address86 S 14th St, San Jose, CA 95112-2015(408) 510-7080(408) 261-7777PECOS EnrollmentBased on the most recent information from CMS, provider Khadeja Tran does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1336712744Provider TypeIndividualFull NameTran, KhadejaGenderFemaleSole ProprietorNoEnumeration Date7/22/2021Last Updated8/29/2023Contact InformationPractice LocationPractice Address86 S 14th St, San Jose, CA 95112-2015Phone(408) 510-7080Fax(408) 510-7081Mailing LocationMailing Address1922 The Alameda Ste 316, San Jose, CA 95126-1461Phone(408) 261-7777Fax(408) 642-6052Provider TaxonomiesCodeDescriptionLicenseCode104100000XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense116272CaliforniaCode101YM0800XDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted IssuerCode171M00000XDescriptionCase Manager/Care CoordinatorOther Service ProvidersLicenseUnlisted Issuer