Eunice Jill Canonizado Phan, MSN, FNP-BC, FNP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

NP95018278 Issued in CA

Practice address

661 W 1St St Ste G
Tustin, CA 92780-2939

Phone

(714) 665-9890

Fax

(714) 665-9891

NPI assigned

Oct 17, 2021

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Memorialcare Medical FoundationGroup PAC ID 8729277314, 555 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Memorialcare Medical Foundation

  • Clinic/Center
  • Fountain Valley, CA
  • NPI 1205167350

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Families Together of Orange County

  • Clinic/Center
  • Tustin, CA
  • NPI 1194122457
  Medicare reassignment NPD
• Families Together of Orange County

  • Federally Qualified Health Center (FQHC)
  • Tustin, CA
  • NPI 1861253080
  NPD
• Families Together of Orange County

  • Federally Qualified Health Center (FQHC)
  • Tustin, CA
  • NPI 1114788239
  NPD (past)

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

{
    "created_epoch": "1634428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761091200000",
    "number": "1558024570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1818 S STATE COLLEGE BLVD UNIT 248",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928068908",
            "telephone_number": "619-208-6882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "661 W 1ST ST STE G",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927802939",
            "telephone_number": "714-665-9890",
            "fax_number": "714-665-9891"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1818 S State College Blvd",
            "address_purpose": "LOCATION",
            "city": "Anaheim",
            "state": "CA",
            "postal_code": "928066053",
            "country_code": "US",
            "telephone_number": "619-208-6882",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11180 Warner Ave Ste 353",
            "address_purpose": "LOCATION",
            "city": "Fountain Valley",
            "state": "CA",
            "postal_code": "927087516",
            "country_code": "US",
            "telephone_number": "714-968-6789",
            "fax_number": "714-202-2626",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9918 Katella Ave Ste A-C",
            "address_purpose": "LOCATION",
            "city": "Anaheim",
            "state": "CA",
            "postal_code": "928046465",
            "country_code": "US",
            "telephone_number": "714-644-9494",
            "fax_number": "714-644-9894",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAN",
        "first_name": "EUNICE JILL",
        "middle_name": "CANONIZADO",
        "credential": "MSN, FNP-BC, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-17",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP95018278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://memorialcare.org/fhir/api/FHIR/R4/",
            "affiliation": "Y",
            "endpointDescription": "MemorialCare FHIR Endpoint",
            "affiliationName": "MemorialCare Medical Foundation",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "17360 Brookhurst St",
            "city": "Fountain Valley",
            "state": "CA",
            "country_code": "US",
            "postal_code": "927083720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lorna Pham, PSY.D
• Mary Pham, PHARM.D
• Melinda Pham, DC
• My Nguyen Pham
• Allyson Tram Phan, FNP
• Kathy Phan
• Matt Phan, D.M.D.
• Mindy Thanh Phan, PA-C
• Alyssa Phillips, AMFT
• Clifford M Phipps, DDS

• Nurse Practitioner in Tustin, CA
• Providers in Tustin, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.