Jacklynne Phan

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA6777 Issued in CA

Practice address

4282 Genesee Ave Ste 201
San Diego, CA 92117-4964

Phone

(858) 746-7882

Fax

(858) 505-1918

NPI assigned

Jul 11, 2022

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

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

Physician Assistant

Education

University of Southern California Keck School of Medicine, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sunset ENT IncGroup PAC ID 0648693770, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Sunset ENT Inc.

  • Otolaryngology Physician
  • San Diego, CA
  • NPI 1689297277
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1657497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761609600000",
    "number": "1649904210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4282 GENESEE AVE STE 201",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921174964",
            "telephone_number": "858-746-7882",
            "fax_number": "858-505-1918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4282 GENESEE AVE STE 201",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921174964",
            "telephone_number": "858-746-7882",
            "fax_number": "858-505-1918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "JACKLYNNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-11",
        "last_updated": "2025-10-28",
        "certification_date": "2025-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA6777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diane Vu Phan, PT, DPT
• Diann Thuy Duong Phan, RN
• Dung Ngoc Phan, R.PH.
• Helena Phan
• Hy Phan, M.D.
• Jason Phan, ND
• Jennifer Phan, FNP
• Joanne T Phan, PHARM.D
• Johnny Phan
• Judy Thi Phan, R.D.H

• Physician Assistant in San Diego, CA
• Providers in San Diego, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 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.