Individual provider Active NPI

Diem Phuong Le

  • Adult Psychiatric/Mental Health Registered Nurse
  • Stockton, CA
National Provider Identifier
1437329307
Registry record updated Mar 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0809X
License
95053139 Issued in CA
Practice address
1212 N California St
Stockton, CA 95202-1552
Phone
(209) 468-8686
NPI assigned
Mar 7, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Adult Psychiatric/Mental Health Registered Nurse 163WP0809X 95053139 CA Primary

Addresses

Primary practice location

1212 N California St
Stockton, CA 95202-1552

Mailing address

1001 Potrero Ave
San Francisco, CA 94110-3518
Phone (415) 206-8125

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
95053139CAMDAdult Psychiatric/Mental Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1204848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458172800000",
    "number": "1437329307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 POTRERO AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941103518",
            "telephone_number": "415-206-8125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 N CALIFORNIA ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952021552",
            "telephone_number": "209-468-8686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LE",
        "first_name": "DIEM PHUONG",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-07",
        "last_updated": "2016-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "CA",
            "license": "95053139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2016; 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.