Active NPI
Nam Phuong Thai, LCSW
- Clinical Social Worker
- San Jose, CA
National Provider Identifier
1336465756
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCS25374
- Practice address
- 2101 Alexian Dr Ste C
San Jose, CA 95116-1901 - Phone
- (408) 272-6081
- Fax
- (408) 272-6088
- NPI assigned
- Apr 9, 2010
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCS25374 | CA | Primary |
Addresses
Primary practice location
2101 Alexian Dr Ste C
San Jose, CA 95116-1901
Mailing address
2101 Alexian Dr Ste C
San Jose, CA 95116-1901
Phone (408) 272-6081
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 168385 | Medicaid | CA |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25374 | CA | MD | Addiction (Substance Use Disorder) Counselor |
| LCS25374 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1270771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1391558400000",
"number": "1336465756",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2101 ALEXIAN DR STE C",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951161901",
"telephone_number": "408-272-6081",
"fax_number": "408-272-6088"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2101 ALEXIAN DR STE C",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951161901",
"telephone_number": "408-272-6081",
"fax_number": "408-272-6088"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THAI",
"first_name": "NAM",
"middle_name": "PHUONG",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-04-09",
"last_updated": "2014-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCS25374",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "168385",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.