Active NPI
Kathy Pham
- Dental Hygienist
- Hawthorne, CA
National Provider Identifier
1295061166
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 24691
- Practice address
- 13450 Hawthorne Blvd
Hawthorne, CA 90250-5806 - Phone
- (310) 679-0106
- Fax
- (310) 679-6698
- NPI assigned
- Oct 27, 2009
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 24691 | CA | Primary |
Addresses
Primary practice location
13450 Hawthorne Blvd
Hawthorne, CA 90250-5806
Mailing address
13450 Hawthorne Blvd
Hawthorne, CA 90250-5806
Phone (310) 679-0106
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24691 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1256601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1256601600000",
"number": "1295061166",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13450 HAWTHORNE BLVD",
"city": "HAWTHORNE",
"state": "CA",
"postal_code": "902505806",
"telephone_number": "310-679-0106",
"fax_number": "310-679-6698"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13450 HAWTHORNE BLVD",
"city": "HAWTHORNE",
"state": "CA",
"postal_code": "902505806",
"telephone_number": "310-679-0106",
"fax_number": "310-679-6698"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAM",
"first_name": "KATHY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-10-27",
"last_updated": "2009-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "CA",
"license": "24691",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hawthorne, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.