Brian Phanichkarn, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

90788 Issued in CA

Practice address

39180 Liberty St Ste 220
Fremont, CA 94538-1522

Phone

(415) 735-4899

NPI assigned

Sep 8, 2019

Sex

Male

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)

Enrolled

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

{
    "created_epoch": "1567900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632787200000",
    "number": "1699324152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17247 VIA EL CERRITO",
            "city": "SAN LORENZO",
            "state": "CA",
            "postal_code": "945802736",
            "telephone_number": "415-795-0737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39180 LIBERTY ST STE 220",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381522",
            "telephone_number": "415-735-4899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHANICHKARN",
        "first_name": "BRIAN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-09-08",
        "last_updated": "2021-09-28",
        "certification_date": "2021-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "90788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ann Phan, DO
• Cathy Phan
• Emily Phan, RPH
• Hieucam Phan, MD
• Kelly Thomas Phan
• Thomas E. Phelps, D.D.S.
• Jasmine Phiengsai
• Nicholas Andrew Phillips, M.D.
• Kristina Philpott, M.D.
• Amanda Ashely Phu

• Clinical Social Worker in Fremont, CA
• Providers in Fremont, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2021; 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.