black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

HAITRIEU CONG TA

PRODUCER NON-RESIDENT

License Number:
PRN380242
Status:
First Licensure:
04/11/2021
Cancel Date:
None

Mailing:
WESTLAKE VILLAGE, CA 91362
Phone:
+1 (888) 989-1620
Fax:
+1 (818) 337-0317
Email:
tta@blend-insurance.com

History

License Type Start Date End Date
PRODUCER NON-RESIDENT 04/11/2021

Agency

Name Issue Date License Number Expiration Date Cancel Date
BLEND INSURANCE AGENCY, INC.
05/18/2022 AGN305331 02/21/2025

Employer

Name Issue Date License Number Expiration Date Cancel Date
ACUITY A MUTUAL INSURANCE COMPANY
04/20/2021 PCF155357
FOREMOST INSURANCE COMPANY GRAND RAPIDS, MICHIGAN
04/23/2021 PCF445
TRAVELERS PERSONAL INSURANCE COMPANY
10/04/2023 PCF201268

Authority

Description Issue Date Termination Date Status
CASUALTY 04/11/2021 Active
PROPERTY 04/11/2021 Active

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN):
4805400

Other Addresses

Address Type
WESTLAKE VILLAGE, CA 91362
Office

An active license/permit may still be subject to limitations and restrictions as a result of disciplinary action imposed. Please contact the specific licensing board about specific disciplinary actions.

Date: 05/14/2025 07:24:53 PM