Vicky Pham

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

95021273 Issued in CA

Practice address

12351 Pentagon St
Garden Grove, CA 92841-3326

Phone

(714) 383-4670

NPI assigned

Jun 20, 2022

Sex

Female

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1655683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660867200000",
    "number": "1851022073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4152 KATELLA AVE STE 201",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907206608",
            "telephone_number": "562-598-0600",
            "fax_number": "562-598-0678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12351 PENTAGON ST",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928413326",
            "telephone_number": "714-383-4670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "VICKY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-20",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "95021273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thu Thuy Thi Pham
• Tiffany Thuy Pham, O.D.
• Trinh Thuy Lan Pham
• Tuan Anh Pham, D.P.T.
• VI Pham, M.S.
• Willie Lam Pham
• Phan Chiropractic & Wellness Ctr, Inc
• Anh Thi Phan-Chu, M.S., BCBA
• Anh Minh Phan
• Chau Ngoc Thanh Phan, PHARM.D

• Primary Care Nurse Practitioner in Garden Grove, CA
• Providers in Garden Grove, CA by specialty
• Primary Care Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2022; 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.