Tiffany Phan, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95026174 Issued in CA

Practice address

11100 Warner Ave Ste 368
Fountain Valley, CA 92708-7514

Phone

(714) 410-1025

NPI assigned

Jun 6, 2023

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

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": "1686009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719619200000",
    "number": "1205520855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 SAWBUCK",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926181423",
            "telephone_number": "714-403-8985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11100 WARNER AVE STE 368",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927087514",
            "telephone_number": "714-410-1025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "TIFFANY",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-06",
        "last_updated": "2024-06-29",
        "certification_date": "2024-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "CA",
            "license": "95163375",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95026174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leah Phan, D.O.
• Lillian Phan, M.S., BCBA
• Linh Ngockhanh Phan
• Michael Khai Phan, DC
• Pauline Lee Phan, D.D.S.
• Pharmacore, Inc. (Trinity Mission Pharmacy)
• Philip M. Nisco, D.D.S., Inc
• Phong H Bui Inc
• Don Q Phung, DO
• Lanh Manh Phung, M.D.

• Family Nurse Practitioner in Fountain Valley, CA
• Providers in Fountain Valley, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2024; 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.