Active NPI
Kim Thuy Pham, FNP
- Nurse Practitioner
- Orange, CA
National Provider Identifier
1619622446
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 95018684
- Practice address
- 1801 E Chapman Ave Ste 1
Orange, CA 92867-7775 - Phone
- (657) 272-7577
- NPI assigned
- Feb 21, 2022
- Last updated
- May 28, 2024
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 95018684 | CA | Primary |
Addresses
Primary practice location
1801 E Chapman Ave Ste 1
Orange, CA 92867-7775
Mailing address
8876 Hillery Dr
San Diego, CA 92126-2809
Phone (858) 761-4743
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 |
|---|---|---|---|
| 95018684 | CA | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1645401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716854400000",
"number": "1619622446",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8876 HILLERY DR",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921262809",
"telephone_number": "858-761-4743"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1801 E CHAPMAN AVE STE 1",
"city": "ORANGE",
"state": "CA",
"postal_code": "928677775",
"telephone_number": "657-272-7577"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAM",
"first_name": "KIM",
"middle_name": "THUY",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-02-21",
"last_updated": "2024-05-28",
"certification_date": "2024-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CA",
"license": "95018684",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orange, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 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.