Phung Phan

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

2600 S El Camino Real
San Mateo, CA 94403-2380

Phone

(408) 347-3120

Fax

(408) 347-3121

NPI assigned

Aug 16, 2013

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

Other names 1

• Marie Phan Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Caminar

  dba Olivos

  • Community/Behavioral Health Agency
  • Redwood City, CA
  • NPI 1992252829
  NPD (past)

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

{
    "created_epoch": "1376611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438646400000",
    "number": "1770916413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3009 WALL ST",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951114601",
            "telephone_number": "650-578-8691",
            "fax_number": "650-393-8925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 S EL CAMINO REAL",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944032380",
            "telephone_number": "408-347-3120",
            "fax_number": "408-347-3121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "PHUNG",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-16",
        "last_updated": "2015-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIE",
            "last_name": "PHAN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Irene Reyes Esteves Pham, RDH, MPH
• Nguyen Pham
• Phillip Pham, PHARMD.
• Tracy L. Pham, MD
• Kathy Phan
• Alan Pharn
• Corina Phayboun
• Molly Phelps, MD
• Justin Philips
• Jocelyn Mary Phillips

• Mental Health Counselor in San Mateo, CA
• Providers in San Mateo, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2015; 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.