Tien Vang Phan, MA

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY32425 Issued in CA

Practice address

7228 Hyatt St
San Diego, CA 92111-6102

Phone

(858) 330-4304

NPI assigned

Mar 22, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Miss Tien Phan Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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 and National Provider Directory roles.

• Tien Phan Psychologist, PC

  • Clinical Psychologist
  • San Diego, CA
  • NPI 1902669815
  NPD Authorized official
• Community Research Foundation Inc

  • Community/Behavioral Health Agency
  • San Diego, CA
  • NPI 1225251812
  NPD (past)
• Community Research Foundation Inc

  • Community/Behavioral Health Agency
  • San Diego, CA
  • NPI 1952328700

  Clinical

  NPD (past)
• Head Strong & Ready

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • San Diego, CA
  • NPI 1023587367
  NPD (past)

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

{
    "created_epoch": "1363910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1497097950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5663 BALBOA AVE STE 380",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921112705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7228 HYATT ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921116102",
            "telephone_number": "858-330-4304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "TIEN",
        "middle_name": "VANG",
        "name_prefix": "Miss",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-22",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY32425",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIEN",
            "last_name": "PHAN",
            "prefix": "MISS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Quynh Tien Y Phan
• Ryan Phan, MD
• Tam Phan
• Thi Binh Phan
• Thuy Hong Phan
• Tiffani Phan, M.D.
• Tiffany Phan
• Trang Phan
• Tri Duc Phan, O.D.
• Tuyet Thi Phan, PHARMD

• Clinical Psychologist in San Diego, CA
• Providers in San Diego, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2024; 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.