Elijah Ryan Phoenix, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95032063 Issued in CA

Practice address

215 S Hickory St Ste 114
Escondido, CA 92025-4360

Phone

(866) 905-9410

NPI assigned

Jan 15, 2025

Last updated

Aug 6, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1736899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785974400000",
    "number": "1518778976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9951 HOLDER ST APT 49",
            "city": "CYPRESS",
            "state": "CA",
            "postal_code": "906304009",
            "telephone_number": "618-919-0972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 S HICKORY ST STE 114",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920254360",
            "telephone_number": "866-905-9410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHOENIX",
        "first_name": "ELIJAH",
        "middle_name": "RYAN",
        "name_prefix": "Mr.",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-01-15",
        "last_updated": "2026-08-06",
        "certification_date": "2026-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95032063",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95232470",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• William Morgan Phillips, RADT I
• Donna Phonsane, PHD
• Hardeep Singh Phull, MD
• Anthony Van Phung, M.D.
• Vivian Phung
• Physical Rehabilitation & Hand Centers Inc

• Psychiatric/Mental Health Nurse Practitioner in Escondido, CA
• Providers in Escondido, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2026; 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.