Loan Vu Minh Pham, DNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

16368 Issued in CA

Practice address

4505 Pacific Hwy E Ste C2
Fife, WA 98424-2638

Phone

(714) 880-5065

NPI assigned

Mar 5, 2007

Last updated

Oct 23, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 6

Addresses

Medicare fee-for-service enrollment

Enrolled in CA, WA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Powered by Self Love Oregon LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Keizer, OR
  • NPI 1821730417

  Multi-Specialty, WA

  Medicare reassignment NPD Authorized official
• Selflove Empowerment Institute, Inc

  • Medical Specialty Clinic/Center
  • Santa Ana, CA
  • NPI 1518749019
  Medicare reassignment Authorized official
• Mindful Therapy Group PC

  dba Mindful Therapy Group

  • Clinical Social Worker
  • Mountlake Terrace, WA
  • NPI 1316238678

  Multi-Specialty

  Medicare reassignment NPD
• Minuteclinic Diagnostic Medical Group of Orange County Inc

  • Nurse Practitioner
  • Irvine, CA
  • NPI 1104013879

  Multi-Specialty

  Medicare reassignment NPD
• Providence Facey Medical Foundation

  dba Facey Medical Group

  • Internal Medicine Physician
  • Valencia, CA
  • NPI 1710031588

  Multi-Specialty

  Medicare reassignment NPD
• Providence Facey Medical Foundation

  dba Providence Express Care

  • Multi-Specialty Clinic/Center
  • Irvine, CA
  • NPI 1891348447
  NPD
• Providence Facey Medical Foundation

  dba Exer With Providence

  • Urgent Care Clinic/Center
  • Santa Clarita, CA
  • NPI 1922651561
  NPD

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698019200000",
    "number": "1053440065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3345 MICHELSON DR STE 100",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926120693",
            "telephone_number": "888-227-3312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4505 PACIFIC HWY E STE C2",
            "city": "FIFE",
            "state": "WA",
            "postal_code": "984242638",
            "telephone_number": "714-880-5065"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "CareMore",
            "address_2": "12900 Park Plaza Dr",
            "address_purpose": "LOCATION",
            "city": "Cerritos",
            "state": "CA",
            "postal_code": "90703",
            "country_code": "US",
            "telephone_number": "562-977-4639",
            "fax_number": "562-741-4479",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3345 Michelson Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Irvine",
            "state": "CA",
            "postal_code": "926120693",
            "country_code": "US",
            "telephone_number": "888-227-3312",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAM",
        "first_name": "LOAN",
        "middle_name": "VU MINH",
        "name_prefix": "Miss",
        "credential": "DNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-05",
        "last_updated": "2023-10-23",
        "certification_date": "2023-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MT",
            "license": "NUR-APRN-LIC-173734",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "202101970NP-PP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "16368",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "16368",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61138359",
            "primary": false
        },
        {
            "code": "364SC1501X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Community Health/Public Health",
            "state": "CA",
            "license": "1709",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia Ann Olmstead, C.O.T.A.
• Adrianne Papoff-Wallace, ARNP
• Amanda L Parker, RN
• Eden Patterson
• Craig Peterson, N.D. LAC
• Mary Elizabeth Platt, D.O.
• Deanne Plunkett
• Puget Sound Medical
• Qwibil Clinic
• Denise Lee Raddatz, ARNP, AGNP-C

• Family Nurse Practitioner in Fife, WA
• Providers in Fife, WA by specialty
• Family Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.