Jennie Lynn Pham, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

3100 Telegraph Ave
Oakland, CA 94609

Phone

(510) 869-6511

NPI assigned

Nov 28, 2018

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: jpham227126@direct.cshs.org

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

{
    "created_epoch": "1543363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543363200000",
    "number": "1720558018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 TELEGRAPH AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093239",
            "telephone_number": "510-869-6511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 TELEGRAPH AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "94609",
            "telephone_number": "510-869-6511"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13 Montgomery",
            "address_purpose": "LOCATION",
            "city": "Irvine",
            "state": "CA",
            "postal_code": "926041928",
            "country_code": "US",
            "telephone_number": "949-742-1027",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAM",
        "first_name": "JENNIE",
        "middle_name": "LYNN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-28",
        "last_updated": "2018-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Duyen T. Pham, M.D.
• Dylan Pham
• Elizabeth Pham
• Hai Tan Pham, D.D.S.
• Huong Thu Thi Pham
• Jennifer Pham
• Jennifer Pham, PHARMD
• Kevin Pham
• Kim Hanh Phan Pham, MSW, ASW
• Loi Pham, PHARMACIST

• Physician Assistant in Oakland, CA
• Providers in Oakland, CA by specialty
• Physician Assistant in California

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

Verify at the official NPI Registry.