Tam DO

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95017595 Issued in CA

Practice address

2900 Bristol St Ste B205
Costa Mesa, CA 92626-5948

Phone

(949) 274-4323

Fax

(949) 274-4323

NPI assigned

Jan 25, 2020

Reactivated

Jun 20, 2024

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

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

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prohealth Partners, a Medical GroupGroup PAC ID 2769388412, 236 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Mindful Glow

  • Multi-Specialty Clinic/Center
  • Fountain Valley, CA
  • NPI 1033914924
  Medicare reassignment NPD Authorized official
• Prohealth Partners, a Medical Group

  • Internal Medicine Physician
  • Lakewood, CA
  • NPI 1003949975
  Medicare reassignment Care Compare group NPD
• Grow Healthcare Group PC

  • Mental Health Counselor
  • San Jose, CA
  • NPI 1154994846

  Psychiatric/Mental Health

  Medicare reassignment NPD
• Prohealth Partners a Medical Group

  • Family Medicine Physician
  • Long Beach, CA
  • NPI 1386211209
  NPD
• Prohealth Partners, a Medical Group, Inc.

  • Internal Medicine Physician
  • Pico Rivera, CA
  • NPI 1912899394
  NPD
• E-Legacy Apc

  • Family Medicine Physician
  • Costa Mesa, CA
  • NPI 1801667597

  Psychiatric/Mental Health

  NPD (past)
• Prohealth Partners, a Medical Group, Inc.

  • Internal Medicine Physician
  • Long Beach, CA
  • NPI 1639126279
  NPD (past)

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

{
    "created_epoch": "1579910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743811200000",
    "number": "1801426192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18111 BROOKHURST ST STE 5400",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927086728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 BRISTOL ST STE B205",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926265948",
            "telephone_number": "949-274-4323",
            "fax_number": "949-274-4323"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24451 Health Center Dr",
            "address_purpose": "LOCATION",
            "city": "Laguna Hills",
            "state": "CA",
            "postal_code": "926533689",
            "country_code": "US",
            "telephone_number": "949-837-4500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18111 Brookhurst St Ste 5400",
            "address_purpose": "LOCATION",
            "city": "Fountain Valley",
            "state": "CA",
            "postal_code": "927086728",
            "country_code": "US",
            "telephone_number": "949-274-4323",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DO",
        "first_name": "TAM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-25",
        "last_updated": "2025-04-05",
        "certification_date": "2025-04-05",
        "deactivation_date": "2020-08-10",
        "reactivation_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95017595",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95017595",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95017595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina Thanh DO, DDS
• Elizabeth Ngoc DO
• Hau DO, MD
• Matthew M DO, D.P.M., DABMSP
• Natalie DO, PHD
• Tamy DO
• Thanhtuyen DO, MD
• Vivian DO
• Linda Ngoc Doan
• Loi Doan, DO

• Psychiatric/Mental Health Nurse Practitioner in Costa Mesa, CA
• Providers in Costa Mesa, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 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.