Johnson Phong Nguyen

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

2690 Illinois St
East Palo Alto, CA 94303-1231

Phone

(650) 521-0861

NPI assigned

May 5, 2022

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1651708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651708800000",
    "number": "1447996293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2690 ILLINOIS ST",
            "city": "EAST PALO ALTO",
            "state": "CA",
            "postal_code": "943031231",
            "telephone_number": "650-521-0861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2690 ILLINOIS ST",
            "city": "EAST PALO ALTO",
            "state": "CA",
            "postal_code": "943031231",
            "telephone_number": "650-521-0861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "JOHNSON",
        "middle_name": "PHONG",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-05",
        "last_updated": "2022-05-05",
        "certification_date": "2022-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Quron Rayshad Myle
• Bertha Navarro, RDH
• Clarrisa Rocio Navarro, R.N.
• Minh Nguyen Dang
• Catherine Kim Nguyen, DDS
• Kristy Mai Nishikawa, PHARMD
• Noble Transportation LLC
• Sandra Teresa Nova, R.N.
• Ruth Judith Nunez Lopez
• Fabrienne Fritzi Lucas Ocampo

• Community Health Worker in East Palo Alto, CA
• Providers in East Palo Alto, CA by specialty
• Community Health Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2022; 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.