Anh Phuong Ha, PHD

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

34298 Issued in CA

Practice address

100 Shoreline Hwy Ste 100
Mill Valley, CA 94941-3645

Phone

(415) 877-4408

NPI assigned

Jul 5, 2023

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

Enrolled in CA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Kandm Neuropsychology, a Psychology CorporationGroup PAC ID 8921373184, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• K&M Neuropsychology, a Psychology Corporation

  • Clinic/Center
  • Mill Valley, CA
  • NPI 1760900831
  Medicare reassignment Care Compare group NPD
• California Pacific Medical Group, Inc.

  • Multi-Specialty Clinic/Center
  • Oakland, CA
  • NPI 1275002453
  NPD (past)

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

{
    "created_epoch": "1688515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688515200000",
    "number": "1144907775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "554 LASSEN ST",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940223910",
            "telephone_number": "504-722-8730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SHORELINE HWY STE 100",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "949413645",
            "telephone_number": "415-877-4408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HA",
        "first_name": "ANH",
        "middle_name": "PHUONG",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-05",
        "last_updated": "2023-07-05",
        "certification_date": "2023-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CA",
            "license": "34298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marsha Guisard, MD
• Jean A Gustafson, M.D.
• Cara Mae Guyot
• Christy Danielle Guzman, N.D., EAMP
• Tracy Gwin
• Analise Elisabeth Hagstrom, NP
• Ellen Hammerle, PH.D., MFT
• Ashraf Hanafy, LMT
• Thomas R. Hansen, M.D.
• Anne Happel, MA

• Clinical Neuropsychologist in Mill Valley, CA
• Providers in Mill Valley, CA by specialty
• Clinical Neuropsychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.