Debra Pham, LVN

Primary specialty

Licensed Vocational NurseTaxonomy code 164X00000X

License

683168 Issued in CA

Practice address

15519 Crenshaw Blvd
Gardena, CA 90249-4525

Phone

(310) 679-9126

NPI assigned

Jun 29, 2016

Last updated

Aug 23, 2022By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: debraramirez-tarzanatc@lacsapc.netsmartdirect.net

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.

• Los Angeles County Department of Public Health

  • Public Health or Welfare Agency
  • Alhambra, CA
  • NPI 1700090834
  NPD
• Clare Matrix

  dba CLARE Foundation Inc., dba MATRIX Institute on Addictions

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Los Angeles, CA
  • NPI 1235349267
  NPD (past)

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

{
    "created_epoch": "1467158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661212800000",
    "number": "1497106561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15519 CRENSHAW BLVD",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902494525",
            "telephone_number": "310-679-9126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15519 CRENSHAW BLVD",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902494525",
            "telephone_number": "310-679-9126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "DEBRA",
        "name_prefix": "Ms.",
        "credential": "LVN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-29",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "683168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jaya Pettiford
• Peyman Banooni Medical Group, Inc
• Adeola Lara Peyton
• Claudia Gaye Peyton, PH.D., OTR/L
• Dat Xuan Joanne Pham, BCBA
• Loan Phuong Pham
• Nellia Vuong Pham
• Thuy Tran Pham, LCSW
• Trung Minh Pham
• Peter Binh Phan, DMD

• Licensed Vocational Nurse in Gardena, CA
• Providers in Gardena, CA by specialty
• Licensed Vocational Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 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.