Peter Pham, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95019677 Issued in CA

Practice address

1100 W Town and Country Rd Ste 1239
Orange, CA 92868-4600

Phone

(949) 229-0854

Fax

(870) 201-4413

NPI assigned

Feb 13, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 6

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: peter.pham.1@30982.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Grow Healthcare Group PC

  • Mental Health Counselor
  • San Jose, CA
  • NPI 1154994846

  Psychiatric/Mental Health

  Medicare reassignment NPD
• Doc1 Medical Group Professional Corporation

  • Multi-Specialty Clinic/Center
  • Chino, CA
  • NPI 1922776996
  NPD (past)

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

{
    "created_epoch": "1550016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785801600000",
    "number": "1366908543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 W TOWN AND COUNTRY RD STE 1250",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684633",
            "telephone_number": "949-229-0854",
            "fax_number": "870-201-4413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 W TOWN AND COUNTRY RD STE 1239",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684600",
            "telephone_number": "949-229-0854",
            "fax_number": "870-201-4413"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2719 Hollywood Blvd # L-264",
            "address_purpose": "LOCATION",
            "city": "Hollywood",
            "state": "FL",
            "postal_code": "330204821",
            "country_code": "US",
            "telephone_number": "949-229-0854",
            "fax_number": "870-201-4413",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9400 SW Beaverton Hillsdale Hwy Ste 250",
            "address_purpose": "LOCATION",
            "city": "Beaverton",
            "state": "OR",
            "postal_code": "970053300",
            "country_code": "US",
            "telephone_number": "949-229-0854",
            "fax_number": "870-201-4413",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "473 S Carnegie Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "San Bernardino",
            "state": "CA",
            "postal_code": "924084201",
            "country_code": "US",
            "telephone_number": "714-410-6588",
            "fax_number": "870-201-4413",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "611 Gateway Blvd Ste 150",
            "address_purpose": "LOCATION",
            "city": "South San Francisco",
            "state": "CA",
            "postal_code": "940807066",
            "country_code": "US",
            "telephone_number": "949-229-0854",
            "fax_number": "870-201-4413",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9920 Pacific Heights Blvd Ste 150",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921214361",
            "country_code": "US",
            "telephone_number": "714-410-6588",
            "fax_number": "870-201-4413",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "633 W 5th St Fl 26",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900712053",
            "country_code": "US",
            "telephone_number": "714-410-6588",
            "fax_number": "870-201-4413",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAM",
        "first_name": "PETER",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-13",
        "last_updated": "2026-08-04",
        "certification_date": "2026-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11021928",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95019677",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "10031892",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NV",
            "license": "882787",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95181593",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1170196",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mychelle N. Pham, M.D.
• Nghia Trung Pham, MD
• Ngocdiep Claudette Pham, NP
• Nguyen Phuong Quyn Pham
• Nguyen Tuong Vy Pham
• Peter Huy Pham, M.D.
• Ronald Pham, DDS
• Sharon Thu Diem Pham, MD
• Sophia Kim Pham
• Stephanie Pham

• Psychiatric/Mental Health Nurse Practitioner in Orange, CA
• Providers in Orange, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.