Active NPI
Kathleen Phan
- Pharmacist
- San Jose, CA
National Provider Identifier
1497317150
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 56792
- Practice address
- 844 Blossom Hill Rd
San Jose, CA 95123-2725 - Phone
- (408) 972-2862
- NPI assigned
- Jul 2, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 56792 | CA | Primary |
Addresses
Primary practice location
844 Blossom Hill Rd
San Jose, CA 95123-2725
Mailing address
844 Blossom Hill Rd
San Jose, CA 95123-2725
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | 763rx@savemart.com |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 56792 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1562025600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1562025600000",
"number": "1497317150",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "844 BLOSSOM HILL RD",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951232725"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "844 BLOSSOM HILL RD",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951232725",
"telephone_number": "408-972-2862"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAN",
"first_name": "KATHLEEN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-07-02",
"last_updated": "2019-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "56792",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "763rx@savemart.com",
"affiliation": "N",
"address_1": "844 Blossom Hill Rd",
"city": "San Jose",
"state": "CA",
"country_code": "US",
"postal_code": "951232725",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.