Julie Ann Huat Phenco, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A124059 Issued in CA

Practice address

101 Parkshore Dr
Folsom, CA 95630-4726

Phone

(916) 580-3240

Fax

(916) 840-7664

NPI assigned

Jul 13, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

County of San JoaquinGroup PAC ID 6002703436, 199 clinicians

Psynergy Programs, Inc.Group PAC ID 5193903813, 16 clinicians

County of SolanoGroup PAC ID 7911893177, 30 clinicians

County of San Luis ObispoGroup PAC ID 9032020094, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• County of San Luis Obispo

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Paso Robles, CA
  • NPI 1134287634
  Medicare reassignment Care Compare group NPD
• County of Solano

  • Public Health or Welfare Agency
  • Fairfield, CA
  • NPI 1508072588
  Medicare reassignment Care Compare group NPD
• Psynergy Programs Inc.

  • Community/Behavioral Health Agency
  • Morgan Hill, CA
  • NPI 1801934450
  Medicare reassignment Care Compare group NPD
• San Joaquin Behavioral Health Services

  • Community/Behavioral Health Agency
  • Stockton, CA
  • NPI 1215028931
  Medicare reassignment Care Compare group NPD
• County of Sacramento

  • Adult Mental Health Clinic/Center
  • Sacramento, CA
  • NPI 1043386659
  Medicare reassignment NPD
• County of Tulare

  • Community/Behavioral Health Agency
  • Visalia, CA
  • NPI 1407304678
  Medicare reassignment NPD
• County of Sacramento

  • Radiology Clinic/Center
  • Sacramento, CA
  • NPI 1508936030
  NPD
• County of Sacramento

  • Adult Mental Health Clinic/Center
  • Sacramento, CA
  • NPI 1750601704
  NPD
• County of San Joaquin

  • Multi-Specialty Clinic/Center
  • Manteca, CA
  • NPI 1417407636
  NPD
• County of San Luis Obispo

  • Psychiatric Hospital
  • San Luis Obispo, CA
  • NPI 1861698300
  NPD
• County of Solano

  • Federally Qualified Health Center (FQHC)
  • Fairfield, CA
  • NPI 1083845275
  NPD
• County of Solano

  • Adult Companion
  • Vacaville, CA
  • NPI 1740402452
  NPD

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

{
    "created_epoch": "1184284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711584000000",
    "number": "1154520708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 PARKSHORE DR",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956304726",
            "telephone_number": "916-580-3240",
            "fax_number": "916-840-7664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 PARKSHORE DR",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956304726",
            "telephone_number": "916-580-3240",
            "fax_number": "916-840-7664"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9343 Tech Center Dr Ste 110",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958262592",
            "country_code": "US",
            "telephone_number": "408-465-8280",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4604A Roosevelt Ave",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958204520",
            "country_code": "US",
            "telephone_number": "408-465-8280 x1800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHENCO",
        "first_name": "JULIE ANN",
        "middle_name": "HUAT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-13",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A124059",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810015806",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tiffany H Phan, OD, FAAO
• Alicia Cherie Pharis
• Aida S. Phelan, M.D.
• Timothy Edwin Phelan, M.D.
• Tracy Phelps
• Nayah Phetdara
• Philip J Orisek, M.D. Inc.
• Corrie Deann Phipps, SLPA
• Darcy Pierce
• Kaylee Pimentel

• Psychiatry Physician in Folsom, CA
• Providers in Folsom, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2024; 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.