Individual provider Active NPI

Vanna Vo

  • Physician Assistant
  • San Diego, CA
National Provider Identifier
1053907279
Registry record updated Jul 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
59746 Issued in CA
Practice address
9888 Carroll Centre Rd Ste 118
San Diego, CA 92126-4580
Phone
(858) 354-1304
Fax
(858) 210-7177
NPI assigned
Dec 13, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X 59746 CA Primary

Addresses

Primary practice location

9888 Carroll Centre Rd Ste 118
San Diego, CA 92126-4580

Mailing address

1233 Sandy Cape CT
San Diego, CA 92154-5800
Phone (619) 565-8960

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
59746CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Clear Insight Psychiatry, Inc PastSince Jul 16, 2023 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1607817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1053907279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1233 SANDY CAPE CT",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921545800",
            "telephone_number": "619-565-8960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9888 CARROLL CENTRE RD STE 118",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921264580",
            "telephone_number": "858-354-1304",
            "fax_number": "858-210-7177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VO",
        "first_name": "VANNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-13",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "59746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2023; 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.