Quynh Tien Y Phan

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-18-30247 Issued in CA

Practice address

8885 Rio San Diego Dr Ste 340
San Diego, CA 92108-1669

Phone

(619) 436-8203

NPI assigned

Jul 5, 2018

Last updated

Aug 17, 2021By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1530748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629158400000",
    "number": "1134615867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8885 RIO SAN DIEGO DR STE 340",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921081669",
            "telephone_number": "619-436-8203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8885 RIO SAN DIEGO DR STE 340",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921081669",
            "telephone_number": "619-436-8203"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3110 Camino Del Rio S Ste 307",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921083832",
            "country_code": "US",
            "telephone_number": "619-795-9925",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9620 Chesapeake Dr Ste 105",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921231324",
            "country_code": "US",
            "telephone_number": "858-505-9083",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAN",
        "first_name": "QUYNH TIEN",
        "middle_name": "Y",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-05",
        "last_updated": "2021-08-17",
        "certification_date": "2021-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-18-30247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judy Thi Phan, R.D.H
• Katy Phan
• Linh Phan
• Lisa Nhu Phan
• Phuong-Nga Thi Phan, PHARMD
• Ryan Phan, MD
• Tam Phan
• Thi Binh Phan
• Thuy Hong Phan
• Tien Vang Phan, MA

• Behavior Analyst in San Diego, CA
• Providers in San Diego, CA by specialty
• Behavior Analyst in California

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