Phalla Ouk, RN

Primary specialty

Infusion Therapy Registered NurseTaxonomy code 163WI0500X

License

719534 Issued in CA

Practice address

2215 Lydia Bradley St
Stockton, CA 95206-6135

Phone

(209) 423-3952

NPI assigned

Dec 29, 2014

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

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1419811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419811200000",
    "number": "1912395906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2215 LYDIA BRADLEY ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952066135",
            "telephone_number": "209-423-3952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2215 LYDIA BRADLEY ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952066135",
            "telephone_number": "209-423-3952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OUK",
        "first_name": "PHALLA",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-29",
        "last_updated": "2014-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WI0500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Infusion Therapy",
            "state": "CA",
            "license": "719534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Christopher Pestano Ote, M.D.
• Luis Otero
• Larry George Otterstetter, DO
• Sarah Otto
• Chanrith Ou
• Pharanya Madeline Oum
• Sophea Onna Oum
• Ourfirst Inc (Emerald Health And Wellness)
• Marisa Erin Ousby
• Ingunn Kristjansdottir Oveny

• Infusion Therapy Registered Nurse in Stockton, CA
• Providers in Stockton, CA by specialty
• Infusion Therapy Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2014; 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.