Pauline Quynh Phan

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

20A19931 Issued in CA

Practice address

902 S Myrtle Ave
Monrovia, CA 91016-3427

Phone

(626) 357-3258

NPI assigned

Apr 4, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

West Virginia School of Osteopathic Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Crossroads Institute for Psychotherapy and Assessment, IncGroup PAC ID 9638391949, 7 clinicians

Pacific ClinicsGroup PAC ID 4082008420, 72 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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

• Crossroads Institute for Psychotherapy and Assessment, Inc

  • Clinical Psychologist
  • Torrance, CA
  • NPI 1831432806
  Medicare reassignment Care Compare group NPD
• Pacific Clinics

  • Community/Behavioral Health Agency
  • Campbell, CA
  • NPI 1255496105
  Medicare reassignment Care Compare group NPD
• Pacific Clinics

  • Community/Behavioral Health Agency
  • Fresno, CA
  • NPI 1336458934
  NPD
• Pacific Clinics

  • Community/Behavioral Health Agency
  • Pasadena, CA
  • NPI 1548928013
  NPD
• Unlv Medicine

  • Internal Medicine Physician
  • Las Vegas, NV
  • NPI 1407397235
  NPD (past)

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

{
    "created_epoch": "1554336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730419200000",
    "number": "1417419680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 S MYRTLE AVE",
            "city": "MONROVIA",
            "state": "CA",
            "postal_code": "910163427",
            "telephone_number": "626-357-3258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 S MYRTLE AVE",
            "city": "MONROVIA",
            "state": "CA",
            "postal_code": "910163427",
            "telephone_number": "626-357-3258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "PAULINE",
        "middle_name": "QUYNH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-04",
        "last_updated": "2024-11-01",
        "certification_date": "2024-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "20A19931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Branda Phamdo
• Alicia Phan
• Jason Phan
• Kristine Phan
• Naomi Phan
• Peter Anthony Phan, NONE
• Serena A Phan, NONE
• Shay Phan
• Debra Pharr
• Kiara Pharr

• Psychiatry Physician in Monrovia, CA
• Providers in Monrovia, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.