Evonne Hoa Phan

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95009102 Issued in CA

Practice address

18433 Roscoe Blvd Ste 106
Northridge, CA 91325-4129

Phone

(818) 435-8819

NPI assigned

Aug 6, 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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Los Angeles Hematology-Oncology Medical Group

  • Specialist
  • Los Angeles, CA
  • NPI 1457409674
  Medicare reassignment NPD
• Los Angeles Hematology-Oncology Medical Group

  • Non-Pharmacy Dispensing Site
  • Glendale, CA
  • NPI 1952516627
  NPD

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

{
    "created_epoch": "1533513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572912000000",
    "number": "1922586437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18000 STUDEBAKER RD STE 800",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907032671",
            "telephone_number": "562-735-3226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18433 ROSCOE BLVD STE 106",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913254129",
            "telephone_number": "818-435-8819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "EVONNE HOA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-06",
        "last_updated": "2019-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95009102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Pesicka, CCC-SLP
• Eduardo Federico Pesqueira
• Hannah Peterson
• Andrew Ngoc-Minh Pham, PHARMD
• Tra Mi N Pham
• Raymond Thanhle Phan, DO
• Philip S Shore M D Inc
• Beth Jo Phillips, PT, DPA
• Emily Phung
• Thu Phung, MSW, LCSW

• Family Nurse Practitioner in Northridge, CA
• Providers in Northridge, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.