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NPI Code Detail

MEDICARE: MS. TINA PHAM

MEDICARE:  MS. TINA  PHAM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family TherapistMFT-979HI
2101YM0800XMental Health CounselorLPCC18516CA
3106H00000XMarriage & Family TherapistLMFT10000651MA
4106H00000XMarriage & Family TherapistLMFT151829CA

General Provider Information

NPI Number : 1457010548
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. TINA PHAM
Provider Business Mailing Address
First Line : 150 N SANTA ANITA AVE STE 800
Second Line :
City : ARCADIA
State : CA
Zip : 91006-3129
Country : US
Telephone Number : 626-604-6240
Fax Number :
Provider Business Practice Location Address
First Line : 150 N SANTA ANITA AVE STE 800
Second Line :
City : ARCADIA
State : CA
Zip : 91006-3129
Country : US
Telephone Number : 626-604-6240
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/16/2021
Last Update Date : 01/26/2026

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Directions to “ MS. TINA PHAM ” Practice Location

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