Corrine Thanh Ngoc Phan, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

100441 Issued in CA

Practice address

995 Gateway Center Way
Suite 300
San Diego, CA 92102-4500

Phone

(619) 398-2156

Fax

(619) 398-2168

NPI assigned

Jul 14, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1468454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634774400000",
    "number": "1003269051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "995 GATEWAY CENTER WAY",
            "address_2": "SUITE 300",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92102",
            "telephone_number": "619-398-2156",
            "fax_number": "619-398-2168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "995 GATEWAY CENTER WAY",
            "address_2": "SUITE 300",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921024500",
            "telephone_number": "619-398-2156",
            "fax_number": "619-398-2168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "CORRINE",
        "middle_name": "THANH NGOC",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-14",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "83594",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "100441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Quynhphi Phan, FNP-C
• Anthony Ein Phan
• Bao Phan, ATC
• Christina Phan, PHARMD
• Cindy Mai Phan
• Diana Elizabeth Phan, ND
• Diana Thao Phan, SCM
• Diane Vu Phan, PT, DPT
• Diann Thuy Duong Phan, RN
• Dung Ngoc Phan, R.PH.

• Social Worker in San Diego, CA
• Providers in San Diego, CA by specialty
• Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2021; 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.