Active NPI
Kristie Pham
- Behavior Analyst
- Garden Grove, CA
National Provider Identifier
1154880805
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 12395 Lewis St Ste 202
Garden Grove, CA 92840-4694 - Phone
- (714) 867-6384
- NPI assigned
- Mar 12, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | Primary |
Addresses
Primary practice location
12395 Lewis St Ste 202
Garden Grove, CA 92840-4694
Mailing address
5109 W 7TH St
Santa Ana, CA 92703-2528
Phone (714) 414-7504
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1552348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560211200000",
"number": "1154880805",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5109 W 7TH ST",
"city": "SANTA ANA",
"state": "CA",
"postal_code": "927032528",
"telephone_number": "714-414-7504"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12395 LEWIS ST STE 202",
"city": "GARDEN GROVE",
"state": "CA",
"postal_code": "928404694",
"telephone_number": "714-867-6384"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAM",
"first_name": "KRISTIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-03-12",
"last_updated": "2019-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Garden Grove, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.