Individual provider Active NPI

Joanna Ha Pham

  • Physician Assistant
  • Monterey, CA
National Provider Identifier
1417743261
Registry record updated Jul 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
66631 Issued in CA
Practice address
9781 Blue Larkspur LN Ste 100
Monterey, CA 93940-6509
Phone
(831) 333-9008
Fax
(831) 333-9010
NPI assigned
Apr 17, 2025
Last updated
Jul 25, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 66631 CA Primary

Addresses

Primary practice location

9781 Blue Larkspur LN Ste 100
Monterey, CA 93940-6509

Mailing address

47 New Scotland Ave # MC-4
Albany, NY 12208-3412
Phone (518) 262-5251

Other practice location 1

204 Green Valley Rd
Freedom, CA 95019-3135
Phone (831) 728-2005

Other practice location 2

47 New Scotland Ave # Mc-4
Albany, NY 12208-3412
Phone (518) 262-5251

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250808001971 CA Practitioner - Physician Assistant 9234637299 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Csi Medical GroupGroup PAC ID 5890916845, 104 clinicians

Practice addresses (Care Compare)

18988 Cox Ave
Suite B
Saratoga, CA 95070-4154
Phone (408) 253-4407

204 Green Valley Rd
Freedom, CA 95019-3135
Phone (831) 728-2005

9781 Blue Larkspur LN
Suite 100
Monterey, CA 93940-6509
Phone (831) 333-9008

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
David a South MD & Kim M Albridge MD a Medical Corporation Past Accepting new patients

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1744848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753401600000",
    "number": "1417743261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 NEW SCOTLAND AVE # MC-4",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122083412",
            "telephone_number": "518-262-5251",
            "fax_number": "518-262-0484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9781 BLUE LARKSPUR LN STE 100",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939406509",
            "telephone_number": "831-333-9008",
            "fax_number": "831-333-9010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "204 Green Valley Rd",
            "address_purpose": "LOCATION",
            "city": "Freedom",
            "state": "CA",
            "postal_code": "950193135",
            "country_code": "US",
            "telephone_number": "831-728-2005",
            "fax_number": "831-728-3310",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "47 New Scotland Ave # Mc-4",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122083412",
            "country_code": "US",
            "telephone_number": "518-262-5251",
            "fax_number": "518-262-0484",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAM",
        "first_name": "JOANNA",
        "middle_name": "HA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-17",
        "last_updated": "2025-07-25",
        "certification_date": "2025-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "66631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monterey, CA

Sources for this page

Verify at the official NPI Registry.