Vivian T Pham, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95024496 Issued in CA

Practice address

1900 W Garvey Ave S Ste 240
West Covina, CA 91790-2655

Phone

(310) 294-9027

NPI assigned

Mar 14, 2023

Sex

Female

Sole proprietor

Yes

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

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

{
    "created_epoch": "1678752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725494400000",
    "number": "1538860754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 W GARVEY AVE S STE 240",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917902655",
            "telephone_number": "310-294-9027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 W GARVEY AVE S STE 240",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917902655",
            "telephone_number": "310-294-9027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "VIVIAN",
        "middle_name": "T",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-14",
        "last_updated": "2024-09-05",
        "certification_date": "2024-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95024496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Juan Pablo Pesqueira Gonzalez, MD
• Peter J Lee DDS Inc (Star Bright Orthodontics)
• Tyler Andrew Peterson, DO
• Sonja Singleton Peverieri, M.A.
• Anthony Tuan Pham
• Andy Hoang Phan, PHARMD
• Anthony Wong Phan
• Henry Phan
• Luong Van Phan, DDS
• Pharmedquest Pharmacy Services (Avita Pharmacy 1012)

• Family Nurse Practitioner in West Covina, CA
• Providers in West Covina, CA by specialty
• Family Nurse Practitioner in California

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