Taryn Lee Phanthanusorn, IBCLC

Primary specialty

Lactation Consultant (Non-RN)Taxonomy code 174N00000X

License

11242387 Issued in CA

Practice address

23315 Via Bahia
Mission Viejo, CA 92691-2115

Phone

(949) 677-7510

NPI assigned

Jan 26, 2015

Sex

Female

Sole proprietor

No

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

State licenses

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

{
    "created_epoch": "1422230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422230400000",
    "number": "1164812467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23315 VIA BAHIA",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926912115",
            "telephone_number": "949-677-7510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23315 VIA BAHIA",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926912115",
            "telephone_number": "949-677-7510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHANTHANUSORN",
        "first_name": "TARYN",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "IBCLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-26",
        "last_updated": "2015-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": "CA",
            "license": "11242387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Duc Quy Pham, MD
• Hesper Pham, O.D.
• Jacqueline Pham
• Quyen Van Le Pham, PHARM.D
• Sarah Pham, DDS
• Pharmedquest Pharmacy Services
• Jaya Philipose, M.D.
• D. Beth Philipp, OT
• Ashley Kristen Phillips
• Elizabeth Phillips

• Lactation Consultant (Non-RN) in Mission Viejo, CA
• Providers in Mission Viejo, CA by specialty
• Lactation Consultant (Non-RN) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2015; 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.