Active NPI
Diep Phan
- Student in an Organized Health Care Education/Training Program
- Stockton, CA
National Provider Identifier
1548741176
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- 41006
- Practice address
- 7720 Lorraine Ave Ste 102
Stockton, CA 95210-4203 - Phone
- (209) 957-8787
- NPI assigned
- Aug 22, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 41006 | CA | Primary |
Addresses
Primary practice location
7720 Lorraine Ave Ste 102
Stockton, CA 95210-4203
Mailing address
9485 Heinlein CT
Sacramento, CA 95829-6094
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534896000000",
"number": "1548741176",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9485 HEINLEIN CT",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958296094"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7720 LORRAINE AVE STE 102",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952104203",
"telephone_number": "209-957-8787"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAN",
"first_name": "DIEP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-08-22",
"last_updated": "2018-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "CA",
"license": "41006",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stockton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.