Individual provider Active NPI

Luyen Dinh Pham, MA MFT

  • Marriage & Family Therapist
  • Orange, CA
National Provider Identifier
1386898732
Registry record updated Feb 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT53265 Issued in CA
Practice address
4000 W Metropolitan Dr Ste 405
Orange, CA 92868-3504
Phone
(714) 517-6160
NPI assigned
Nov 12, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 58160 CA
Marriage & Family Therapist 106H00000X LMFT53265 CA Primary

Addresses

Primary practice location

4000 W Metropolitan Dr Ste 405
Orange, CA 92868-3504

Mailing address

1105 W Garry Ave
Santa Ana, CA 92707-3814
Phone (714) 317-5858

Other practice location 1

2183 Fairview Rd
Suite 100
Costa Mesa, CA 92627-5663
Phone (949) 515-5440 ext. 110

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
58160CAMDMarriage & Family Therapist
LMFT53265CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1226448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614038400000",
    "number": "1386898732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 W GARRY AVE",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927073814",
            "telephone_number": "714-317-5858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 W METROPOLITAN DR STE 405",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683504",
            "telephone_number": "714-517-6160"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2183 Fairview Rd",
            "address_2": "SUITE 100",
            "address_purpose": "LOCATION",
            "city": "Costa Mesa",
            "state": "CA",
            "postal_code": "926275663",
            "country_code": "US",
            "telephone_number": "949-515-5440 x110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAM",
        "first_name": "LUYEN",
        "middle_name": "DINH",
        "name_prefix": "Mr.",
        "credential": "MA MFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-11-12",
        "last_updated": "2021-02-23",
        "certification_date": "2021-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "58160",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT53265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2021; 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.