Jennifer Le Ma-Pham, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

69963 Issued in CA

Practice address

4368 Eagle Rock Blvd
Los Angeles, CA 90041-3211

Phone

(626) 888-1112

Fax

(314) 394-1937

NPI assigned

Jan 29, 2016

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

State licenses

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

{
    "created_epoch": "1454025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454025600000",
    "number": "1164880589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11648 GRAVOIS RD",
            "address_2": "STE 140",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631263034",
            "telephone_number": "626-888-1112",
            "fax_number": "314-394-1937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4368 EAGLE ROCK BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900413211",
            "telephone_number": "626-888-1112",
            "fax_number": "314-394-1937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MA-PHAM",
        "first_name": "JENNIFER",
        "middle_name": "LE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-29",
        "last_updated": "2016-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "69963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Stacy Nhi Ma Du Bois, LCSW
• Austin J Ma, MD
• Brandee Tran Ma, DDS
• Brian Ma, PHARMD
• Candice Ma
• Christina Ma, MD

• Clinical Social Worker in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2016; 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.